Mittoval
Mittoval Uses, Dosage, Side Effects, Food Interaction and all others data.
Mittoval Hydrochloride is a selective antagonist of post-synaptic a1 adrenoreceptors, which are located in the prostate, bladder base, bladder neck, prostatic capsule, and prostatic urethra. Mittoval Hydrochloride relaxes the tone of the prostate smooth muscle, prostate capsule, bladder neck and proximal urethra. It competitively and selectively binds to the post synaptic a1-adrenergic receptors in the lower urinary tract. It also relaxes sympathetic nervous stimulation, reduces resting urethral pressure and inhibits urethral hypertonia-induced sympathetic nervous stimulation. As an uroselective agent, Mittoval Hydrochloride preferentially binds to prostatic a1 receptors, blockage of these receptors result in reduction of BPH symptoms, improvement of urine flow and decreased potential for hypertensive events.
By selectively inhibiting alpha adrenergic receptors in the lower urinary tract, alfuzosin causes smooth muscle relaxation in the bladder neck and prostate, improving urine flow, thereby reducing BPH symptoms. Additionally, alfuzosin reduces the vasoconstrictor effect of catecholamines (epinephrine and norepinephrine), leading to peripheral vasodilation. This leads to a risk of postural hypotension/syncope, and prescribing information warns that caution should be exercised in patients who take nitrates, antihypertensives, or have experienced decreased blood pressure after using other medications.
| Trade Name | Mittoval |
| Availability | Prescription only |
| Generic | Alfuzosin |
| Alfuzosin Other Names | Alfuzosin, Alfuzosina, Alfuzosine, Alfuzosinum |
| Related Drugs | tamsulosin, finasteride, Flomax, prazosin, tadalafil, Cialis |
| Type | |
| Formula | C19H27N5O4 |
| Weight | Average: 389.4488 Monoisotopic: 389.206304377 |
| Protein binding | The protein biding of alfuzosin is moderate and ranges from 82% to 90%. Alfuzosin is 68.2% bound to human serum albumin and 52.5% bound to human serum alpha-glycoprotein. |
| Groups | Approved, Investigational |
| Therapeutic Class | Alpha adrenoceptor blocking drugs |
| Manufacturer | |
| Available Country | Italy |
| Last Updated: | September 19, 2023 at 7:00 am |
Uses
Mittoval Hydrochloride is used for the treatment of the signs and symptoms of benign prostatic hyperplasia(BPH), lower urinary tract symptoms (LUTS) including urinary frequency, nocturia, incomplete emptying and urinary hesitancy associated with BPH.
Mittoval is also used to associated treatment for these conditions: Benign Prostatic Hyperplasia (BPH)
How Mittoval works
Alpha(1)-adrenoreceptors are found in the prostate, bladder base, bladder neck, prostatic capsule, and prostatic urethra; their activation may lead to contraction of smooth muscle and urinary symptoms in patients with BPH. Mittoval selectively binds to and inhibits alpha(1)-adrenergic receptors in the lower urinary tract. This leads to the relaxation of smooth muscle in both the prostate and bladder neck, resulting in the improvement in urine flow and a reduction of urinary symptoms.
Dosage
Mittoval dosage
The recommended dosage is one 10 mg Mittoval Hydrochloride tablet daily to be taken immediately after the same meal each day. The tablets should not be chewed or crushed.
Mittoval Hydrochloride tablet should be swallowed whole.
Side Effects
This formulation is generally well tolerated. However the following adverse events have been reported include abdominal pain, dyspepsia, constipation, nausea, impotence, bronchitis, sinusitis and pharyngitis.
Toxicity
The oral LD50 of alfuzosin is 2300 mg/kg in male mice and 1950 mg/kg in female mice. An overdose of alfuzosin can cause hypotension. Cardiovascular support should be initiated immediately. The patient should be kept in the supine position to aid in restoring pressure and managing heart rate. Fluid resuscitation should also be considered in severe cases; sometimes, vasopressors are required. Renal function should be monitored frequently. Dialysis may not be of benefit to alfuzosin protein binding of up to 90%.
Precaution
Mittoval Hydrochloride should not be given to patients with moderate or severe hepatic insufficiency. Caution should be exercised when Mittoval is administered in patients with severe renal insufficiency. If symptoms of angina pectoris should newly appear or worsen, Mittoval Hydrochloride should be discontinued.
Interaction
Mittoval may interact with other alpha-blockers, Atenolol, Cimetidine, Diltiazem, Ketoconazole and Ritonavir.
Food Interaction
- Take after a meal. Take alfuzosin after the same meal everyday. Do not take on an empty stomach.
[Moderate] ADJUST DOSING INTERVAL: Administration of alfuzosin with food enhances oral bioavailability.
According to the manufacturer, extent of absorption is 50% higher when administered under fed conditions compared to fasting conditions.br>
MANAGEMENT: To ensure maximal oral absorption, alfuzosin should be administered with or immediately after a meal.
Mittoval Alcohol interaction
[Moderate] GENERALLY AVOID:
The concurrent use of ethanol and alpha-1 adrenergic blockers may cause increased hypotensive effects.
Patients with aldehyde dehydrogenase deficiencies (primarily Asians) may be at a higher risk of this interaction.
The mechanism has not been determined.
Data exist for prazosin and other alpha adrenergic blockers are expected to interact also.
In addition, any patients taking alpha adrenergic blockers may experience excessive orthostatic hypotension with ethanol ingestion, due to ethanol's unopposed vasodilatory effects in the presence of alpha adrenergic blockade.
Patients who develop
a flushing reaction after ethanol ingestion (indicates a possible aldehyde dehydrogenase deficiency) should be advised to avoid ethanol or limit their intake.
All patients should be warned about the possibility of orthostatic hypotension with concurrent ethanol use.
Mittoval Drug Interaction
Moderate: tadalafil, tadalafil, metoprolol, metoprololUnknown: aspirin, aspirin, aspirin, aspirin, rosuvastatin, rosuvastatin, apixaban, apixaban, omega-3 polyunsaturated fatty acids, omega-3 polyunsaturated fatty acids, cyanocobalamin, cyanocobalamin, ascorbic acid, ascorbic acid, cholecalciferol, cholecalciferol
Mittoval Disease Interaction
Major: hepatic impairmentModerate: QT prolongation, renal impairment, hypotension, cataracts
Volume of Distribution
The volume of distribution of alfuzosin after intravenous administration in healthy volunteers is about 3.2 L/kg. Mittoval distributes heavily to the tissues of the prostate.
Elimination Route
Mittoval is readily absorbed in the gastrointestinal tract and the absolute bioavailability under fed conditions is 49%. In patients over 75 years of age, alfuzosin is absorbed more rapidly and peak plasma levels are higher. One source mentions a bioavailability of 64%. After multiple doses under fed conditions, Cmax is achieved in 8 hours. Cmax and AUC0-24 values are about 13.6 ng/mL and 194 ng·h/mL, respectively. Steady-state plasma concentrations are achieved after the second dose and are 1.2 to 1.6 times higher than after a single dose. With the extended-release formulation, alfuzosin release is sustained over 20 hours with a rate of dissolution ranging between 2 and 12 hours.
Half Life
The apparent elimination half-life of alfuzosin after oral administration is about 10 hours. The terminal half-life is 3-5 hours.
Clearance
Exercise caution if renal clearance is < 30 mL/min. The clearance of alfuzosin is increased in renal insufficiency (with or without dialysis), due to an increase in the free fraction.
Elimination Route
It is partially metabolised and excreted mainly in the bile and faeces. Following oral administration of a radiolabeled alfuzosin solution, the detection of radioactivity after one week was 69% in the feces and 24% in the urine.
Pregnancy & Breastfeeding use
Mittoval Hydrochloride is not indicated for use in pregnant and lactating mother.
Contraindication
Mittoval Hydrochloride tablet is contraindicated for hypersensitivity to Mittoval Hydrochloride, history of orthostatic hypotension, combination with other alpha-1 receptor blockers, hepatic insufficiency.
Special Warning
Efficacy of Mittoval Hydrochloride has not been demonstrated in children aged 2 to 16 years. Therefore Mittoval Hydrochloride is not indicated for use in the paediatric population.
Acute Overdose
Overdose of Mittoval Hydrochloride should lead to hypotension; support of the cardiovascular system is of first importance. Restoration of blood pressure and normalization of heart rate may be accomplished by keeping the patient in the supine position. If this measure is inadequate, then the administration of intravenous fluids should be considered. If necessary, vasopressors should then be used, and the renal function should be monitored and supported as needed.
Storage Condition
Store in a cool and dry place, protected from light
Innovators Monograph
You find simplified version here Mittoval
Mittoval contains Alfuzosin see full prescribing information from innovator Mittoval Monograph, Mittoval MSDS, Mittoval FDA label
FAQ
What is Mittoval used for?
It is used to treat benign prostatic hyperplasia. As an antagonist of the α₁ adrenergic receptor. Mittoval is used to treat the signs and symptoms of benign enlargement of the prostate (benign prostatic hyperplasia or BPH).
How safe is Mittoval?
This study demonstrates the satisfactory long-term safety of this formulation, and its safe use even in at-risk populations. Mittoval may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.
How does Mittoval work?
Mittoval works by relaxing the muscles in the prostate and bladder to allow urine to flow more easily.
What are the common side effects of Mittoval?
Common side effect of Mittoval are include:
- tiredness
- headache
- runny or stuffy nose
- pain
- stomach pain
- heartburn
- constipation
- nausea
- decrease in sexual ability
- sore throat, fever, chills, cough and other signs of infection
Is Mittoval safe during pregnancy?
Mittoval is not for use in women, and the effects of this medicine during pregnancy or in breastfeeding women are unknown. Mittoval is not approved for use by anyone younger than 18 years old.
Is Mittoval safe during breastfeeding?
This Mittoval is not indicated for use in female patients.
Can I drink alcohol with Mittoval?
You are advised not to drink alcohol while you are on Mittoval. Alcohol increases the risk of side-effects from Mittoval, such as feeling faint or dizzy.
Can I drive after taking Mittoval?
You may feel dizzy and weak while taking Mittoval. If this happens do not drive or operate any tools or machines
What is best time to take Mittoval?
To avoid injury from dizziness or fainting, your doctor may tell you to take your first dose of Mittoval with food at bedtime so that your body can get used to its effects. Take this medication regularly to get the most benefit from it. To help you remember, take it after the same meal each day.
How often can I take Mittoval?
Adults, 10 milligrams (mg) once a day. Children, Use is not recommended.
How long does Mittoval take to work?
Mittoval can start to relieve your BPH symptoms around 4 weeks after starting it. It's important that you continue to take Mittoval even if you don't feel better right away.
How long does Mittoval stay in my system?
Following oral administration of Mittoval 10 mg tablets, the apparent elimination half-life is 10 hours.
How long can I take Mittoval?
Mittoval 10 mg administered for 2 years in real practice is effective in improving LUTS and quality of life, and is well tolerated from a cardiovascular perspective, including in elderly men and those receiving antihypertensive co-medication.
Who should not take Mittoval?
You should not take Mittoval if you have moderate to severe liver disease. Mittoval is not approved for use by anyone younger than 18 years old. You should not take Mittoval if you are allergic to it, or if you have: moderate to severe liver disease.
What happens if I miss a dose?
Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.
What happen if I take too much Mittoval?
Taking too much Mittoval may lead to: low blood pressure, with symptoms including dizziness, lightheadedness, and fainting. other problems with your heart.
What happen If I stop taking Mittoval?
If don't take or stop taking Mittoval, you may have increased symptoms of BPH, such as difficulty starting to urinate, straining while trying to urinate, frequent urges to urinate, pain during urination, and dribbling after urination.
Can Mittoval affects my heart ?
Mittoval may cause increased heart rate or decreased blood pressure, which may affect control of angina symptoms. People with angina (chest pain) should stop using this medication if their symptoms reappear or become worse.
Can Mittoval affect my liver?
Don't take Mittoval if you have moderate or severe liver problems. If your liver isn't working well, more of the Mittoval may stay in your body.
Can Mittoval affect my kidneys?
For people with kidney problems: Use this Mittoval with caution if you have severe kidney problems.
