Xatral XL (alfuzosin hydrochloride) is an alpha blocker used to help facilitate urination in men who have benign prostatic hyperplasia (BPH), more commonly called an enlarged prostate.

The XL in Xatral XL indicates it's the extended-release version of the product. Extended-release tablets are taken just once per day, slowly releasing the medication over 24 hours. This is a very convenient option for most men, compared to immediate-release tablets which are taken two or three times per day. However, dosage is more customizable with immediate-release tablets.

Xatral XL only helps facilitate urine flow; it will not influence the size of prostate in any way. Other medications designed to slow, stop, or shrink enlarged prostates may also be prescribed. If the prostate is not otherwise addressed, ending treatment with Xatral XL will likely cause symptoms to return.

What to Expect from Xatral XL

Xatral XL works by relaxing the muscles in the prostate, along the urethra, and at the opening to the bladder. In BPH as the prostate grows these muscles often become increasingly tight, which can restrict urine flow. Symptoms gradually worsen over time and can eventually become uncomfortable and disruptive:

• Difficulty urinating
• Weak urine stream
• Urgent urination
• Frequent urination
• Waking up several times to urinate
• Excessive dribbling at the end of urination
• Inability to fully empty the bladder

If the problem continues untreated more serious complications can develop. Bladder infections are often a problem, and kidney damage can also occur. In some men urine flow can become so impeded that emergency surgery is needed to empty the bladder.

To be clear, not everyone with an enlarged prostate experiences symptoms severe enough to warrant treatment. Likewise not everyone has the same benefit from Xatral XL; some men experience complete relief of symptoms, some only partial, and in others the medication doesn't seem to help at all. If Xatral XL doesn't produce good results speak with a doctor about alternative options.

In most cases, however, men do experience significant relief, and in most cases Xatral XL provides benefit for years.

Dosage & Administration

Xatral XL comes in tablets of 10 mg strength. Tablets must be swallowed whole; splitting, crushing, chewing and so forth will ruin their extended-release properties. Men who have difficulty swallowing whole tablets should speak with a doctor about alternative options.

Tablets should also be taken with food; absorption of the tablets is considerably increased when taken on a full stomach.

Though taken just once per day, taking each tablet at the same time each day is also recommended, to keep levels of the medication steady in the body.

In the majority of cases treatment is:

• Take 10 mg (one tablet) once per day.
• Tablets should be taken with food.
• Treatment may continue for as long as needed.

Most men notice some improvement in symptoms just days after starting Xatral XL, but it can take up to a month before full benefit is seen. Give the medication at least a month, assuming no serious adverse effects develop, before deciding it doesn't work.

Men who have, or are at great risk of developing, other major medical conditions may need adjusted doses. In most cases this will mean switching to immediate-release tablets, which are taken more frequently but are available in lower doses.

Adverse Effects

An important thing to keep in mind about Xatral XL is that the medication will lower blood pressure to some extent. In most cases this is not dangerous, but it can produce symptoms even if blood pressure stays within healthy ranges. Symptoms of low blood pressure include:

• Dizziness
• Fatigue
• Blurry vision
• Nausea
• Clammy skin
• Fainting

Symptoms are usually mild and should stop occurring after the first few weeks of treatment, as the body adjusts to its new, lower blood pressure. If the above become severe, or fainting is experienced, speak with a doctor.

Men who have preexisting low blood pressure are poor candidates for this medication.

Otherwise side effects are usually mild and also transient. Common side effects include:

• Dry mouth
• Headache
• Diarrhea
• Stomach upset

If the above become severe or persistant, speak with a doctor.

Xatral XL can cause complications in patients undergoing eye surgery, even if treatment stopped months prior to the surgery. Ophthalmologists should be notified ahead of time so they may be prepared in case these complications are encountered.