TM Owner Allergan / AbbVie
Rapaflo 8mg Capsule
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Indications & Clinical Uses
- Rapaflo 8 mg capsules contain silodosin, a selective alpha-1A adrenergic receptor blocker approved for treating the signs and symptoms of benign prostatic hyperplasia, BPH, also called an enlarged prostate, in adult men.
- Rapaflo relaxes smooth muscle in the prostate and bladder neck, improving urine flow and reducing urinary symptoms such as hesitancy, weak stream and frequent urination.
- It is licensed from Kissei Pharmaceutical of Japan and distributed in the US by Allergan, now part of AbbVie, with manufacturing by Teva Dupnista in Bulgaria.
- Rapaflo is not approved for treating high blood pressure and should not be used for that purpose.
- It is not indicated for use in women or children, and it does not treat prostate cancer.
Side Effects
- The most common Rapaflo side effect by far is retrograde ejaculation, semen entering the bladder instead of leaving the body during orgasm, affecting around 28% of men compared with under 1% on placebo; this is harmless but should be discussed with a healthcare provider if bothersome.
- Other reported effects include dizziness, diarrhoea, low blood pressure on standing, headache and nasal congestion.
- There is no boxed warning on the Rapaflo label.
- Rapaflo can cause a sudden drop in blood pressure on standing, particularly after the first dose or a dose increase, raising the risk of dizziness or fainting; rise slowly from sitting or lying positions.
- A condition called intraoperative floppy iris syndrome can occur during cataract surgery in men taking or who have taken Rapaflo; tell your eye surgeon about this medicine before any cataract operation.
Precautions & Warnings
- Rapaflo is contraindicated in men with severe kidney impairment, creatinine clearance under 30 mL/min, severe liver impairment, and in those taking strong CYP3A4 inhibitors such as ketoconazole, clarithromycin or ritonavir, because these substantially raise silodosin levels.
- A lower starting regimen and extra caution are needed in moderate kidney impairment.
- Rapaflo can cause orthostatic hypotension, especially when starting treatment or when combined with other blood-pressure-lowering medicines; caution is advised with driving or operating machinery until the effect on blood pressure is known.
- Tell any eye surgeon about Rapaflo use before cataract surgery, because of the risk of intraoperative floppy iris syndrome.
- Rapaflo is intended for men only and has no approved use in women or children.
- It should not be combined with other alpha-blockers used for prostate symptoms or for blood pressure.
Avoid Interactions
- Rapaflo is contraindicated with strong CYP3A4 inhibitors, ketoconazole, itraconazole, clarithromycin, ritonavir and similar drugs, because they can raise silodosin blood levels roughly fourfold, increasing the risk of low blood pressure and dizziness.
- Strong P-glycoprotein inhibitors such as cyclosporine are not recommended alongside Rapaflo.
- Combining Rapaflo with other alpha-blockers, or with PDE5 inhibitors used for erectile dysfunction such as sildenafil or tadalafil, can increase the risk of low blood pressure and should be used with caution and medical guidance.
- Other blood-pressure-lowering medicines may add to Rapaflo's blood-pressure-lowering effect.
- Grapefruit juice can raise silodosin levels and is best avoided in large amounts.
- Tell your healthcare provider and pharmacist about every prescription and over-the-counter medicine you take before starting Rapaflo, especially heart, blood pressure or erectile dysfunction medicines.
References
Frequently Asked Questions
Rapaflo (silodosin) 8 mg is a once-daily capsule for men with benign prostatic hyperplasia, an enlarged prostate. It relaxes muscle in the prostate and bladder neck to ease urinary symptoms like weak stream, hesitancy and frequent urination. Rapaflo is not approved to treat high blood pressure.
Take one Rapaflo 8 mg capsule by mouth once daily with a meal, at about the same time each day. Swallow the capsule whole; do not open, crush or chew it. Taking it with food helps reduce stomach upset and improves how consistently silodosin is absorbed.
The most common Rapaflo side effect is retrograde ejaculation, affecting around 1 in 4 men; it's harmless but can affect fertility. Others include dizziness, diarrhoea and low blood pressure on standing. Seek care for fainting, or tell your eye surgeon about Rapaflo before any cataract surgery.
Avoid strong CYP3A4 inhibitors like ketoconazole, itraconazole or clarithromycin, which are contraindicated with Rapaflo because they raise silodosin levels sharply. Use caution combining it with other alpha-blockers, erectile dysfunction medicines or blood pressure drugs, and rise slowly from sitting to avoid dizziness.
If you miss a Rapaflo dose, skip it and take your next capsule at the usual time the following day; do not take two capsules together. If you stop Rapaflo for several days, restart at the regular 8 mg once-daily dose with a meal rather than doubling up.
Yes. Rapaflo can cause intraoperative floppy iris syndrome during cataract surgery, so tell your eye surgeon you take it beforehand, even if you stopped it earlier. It also commonly causes retrograde ejaculation, which can reduce fertility; discuss this with your doctor if planning to father a child.
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