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Alpha Adrenergic Antagonist
Aka: Alpha Adrenergic Antagonist, Selective Alpha-1a Antagonist, Prazosin, Minipress, Terazosin, Hytrin, Doxazosin, Cardura, Tamsulosin, Flomax, Alfuzosin, Uroxatral, Silodosin, Rapaflo- Indications
- Benign Prostatic Hypertrophy
- Hypertension (not Tamsulosin)
- Mechanism: General
- See Alpha Adrenergic Receptor (Alpha-1 antagonist)
- Mechanism: Benign Prostatic Hypertrophy
- Preparations used in Benign Prostatic Hypertrophy
- Terazosin (Hytrin)
- Doxazosin (Cardura)
- Tamsulosin (Flomax)
- Prazosin (Minipress)
- Rapid relaxation of smooth muscle tone
- Relieves symptoms of urinary obstruction
- May see full effect within 2 weeks
- Does not effect size of Prostate (unlike Proscar)
- Preparations used in Benign Prostatic Hypertrophy
- Preparations: Non-Selective Agents
- Prazosin (Minipress)
- Dose: 1 mg PO bid-tid (Maximum 40 mg/day)
- Less expensive but not available for once daily dose
- Terazosin (Hytrin)
- Dose: 1 mg PO qhs (Maximum 20 mg/day)
- Doxazosin (Cardura)
- Dose: 1 mg PO qd (Maximum 16 mg/day)
- Phenoxybenzamine (Dibenzyline)
- Dose: 10 mg PO bid (Maximum 120 mg/day)
- Prazosin (Minipress)
- Preparations: Selective Alpha-1a Antagonists (Prostate specific agents)
- Precautions
- Still cause Orthostatic Hypotension, fall risk, Head Trauma and Fractures, despite selective nature
- Number needed to harm (NNH): 600 for fall-related hospitalizations, and 1600 for fall-related Fractures
- Welk (2015) BMJ 351:h5398 +PMID:26502947 [PubMed]
- Alfuzosin (Uroxatral, generic)
- Dose: 10 mg once daily
- Contraindicated in moderate to severe liver disease (and Exercise caution in renal disease)
- Silodosin (Rapaflo)
- Dose: 8 mg daily with food (4 mg daily if GFR 30-50 ml/min)
- Contraindicated when GFR <30 ml/min or severe liver disease (Child-Pugh Score 10 or more)
- Tamsulosin (Flomax, generic)
- Dose 0.4 mg orally daily (maximum 0.8 mg/day)
- Precautions
- Combination Alpha-Beta Antagonist (Labetalol or Trandate)
- Oral: 100 mg PO bid (Maximum: 2400 mg/day)
- Intravenous: 20 mg IV q10 minutes (Maximum: 200 mg)
- Adverse effects (Incidence: 7 to 9%)
- Dose at bed and slowly titrate to reduce side effects
- Cardiovascular adverse effects (also occurs with selective agents, albeit less often)
- Dizziness
- Postural Hypotension
- Associated with fall risk and secondary Fracture risk
- Other adverse effects
- Precautions
- Avoid using as monotherapy for Hypertension
- Higher risk of CVA and CHF compared with other agents
- (2000) JAMA 283:1967-75 [PubMed]
- Avoid using as monotherapy for Hypertension
- References
Medication Costs | ||
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Terazosin (on 6/18/2017 at Walmart.com) | ||
Terazosin 10mg | #30 capsules for $4.00 | $0.13 each |
Terazosin 10mg | #90 capsules for $10.00 | $0.11 each |
Terazosin 1mg | #30 capsules for $4.00 | $0.13 each |
Terazosin 1mg | #90 capsules for $10.00 | $0.11 each |
Terazosin 2mg | #30 capsules for $4.00 | $0.13 each |
Terazosin 2mg | #90 capsules for $10.00 | $0.11 each |
Terazosin 5mg | #30 capsules for $4.00 | $0.13 each |
Terazosin 5mg | #90 capsules for $10.00 | $0.11 each |
prazosin (on 5/17/2017 at Medicaid.Gov Pharmacy Drug pricing) | ||
PRAZOSIN 1 MG CAPSULE | Generic | $0.42 each |
PRAZOSIN 2 MG CAPSULE | Generic | $0.67 each |
PRAZOSIN 5 MG CAPSULE | Generic | $1.04 each |
terazosin (on 5/17/2017 at Medicaid.Gov Pharmacy Drug pricing) | ||
TERAZOSIN 1 MG CAPSULE | Generic | $0.06 each |
TERAZOSIN 10 MG CAPSULE | Generic | $0.06 each |
TERAZOSIN 2 MG CAPSULE | Generic | $0.06 each |
TERAZOSIN 5 MG CAPSULE | Generic | $0.06 each |
doxazosin (on 5/17/2017 at Medicaid.Gov Pharmacy Drug pricing) | ||
DOXAZOSIN MESYLATE 1 MG TAB | Generic | $0.29 each |
DOXAZOSIN MESYLATE 2 MG TAB | Generic | $0.26 each |
DOXAZOSIN MESYLATE 4 MG TAB | Generic | $0.28 each |
DOXAZOSIN MESYLATE 8 MG TAB | Generic | $0.27 each |
cardura (on 6/1/2017 at Medicaid.Gov Pharmacy Drug pricing) | ||
CARDURA 2 MG TABLET | Generic | $0.26 each |
CARDURA 4 MG TABLET | Generic | $0.28 each |
CARDURA XL 4 MG TABLET | $4.69 each | |
tamsulosin (on 5/17/2017 at Medicaid.Gov Pharmacy Drug pricing) | ||
TAMSULOSIN HCL 0.4 MG CAPSULE | Generic | $0.14 each |
flomax (on 1/4/2017 at Medicaid.Gov Pharmacy Drug pricing) | ||
FLOMAX 0.4 MG CAPSULE | Generic | $0.14 each |
alfuzosin (on 5/17/2017 at Medicaid.Gov Pharmacy Drug pricing) | ||
ALFUZOSIN HCL ER 10 MG TABLET | Generic | $0.17 each |
uroxatral (on 5/18/2016 at Medicaid.Gov Pharmacy Drug pricing) | ||
UROXATRAL 10 MG TABLET | Generic | $0.17 each |
rapaflo (on 2/22/2017 at Medicaid.Gov Pharmacy Drug pricing) | ||
RAPAFLO 4 MG CAPSULE | $7.30 each | |
RAPAFLO 8 MG CAPSULE | $7.29 each | |
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information. |
Prazosin (C0032912) |
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Definition (MSH) | A selective adrenergic alpha-1 antagonist used in the treatment of HEART FAILURE; HYPERTENSION; PHEOCHROMOCYTOMA; RAYNAUD DISEASE; PROSTATIC HYPERTROPHY; and URINARY RETENTION. |
Definition (NCI) | A synthetic piperazine derivative and an alpha-1 adrenergic receptor inhibitor used primarily as an anti-hypertensive. Prazosin's effects are most pronounced in the large resistance vessels (i.e. arterioles) and result in a decrease in total systemic vascular resistance (SVR) without a rebound or reflex tachycardia. To a lesser extent, this agent also decreases the tone of the bladder sphincter, thereby allowing the opening of the bladder into the urethra and thus relieving the urinary conditions associated with benign prostatic hypertrophy. |
Definition (CSP) | 1-(4-amino-6,7-dimethoxy- 2-quinazolinyl) -4-(2-furoyl) piperazine. |
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | D011224 |
SnomedCT | 367555002, 387283005, 387433003, 76058001, 51505001 |
LNC | LP18588-1, MTHU004704 |
English | Furazosin, Prazosin, Piperazine, 1-(4-amino-6,7-dimethoxy-2-quinazolinyl)-4-(2-furanylcarbonyl)-, 2-[4-(2-furoyl)piperazin-1-yl]-4-amino-6,7-dimethoxyquinazoline, 1-(4-amino-6,7-dimethoxy-2-quinazolinyl)-4-(2-furanylcarbonyl)piperazine, Prazosin [Chemical/Ingredient], PRAZOSIN, prazosin (medication), Furazosin (product), prazosin, Prazosin (product), Prazosin (substance), Furazosin (substance) |
Swedish | Prazosin |
Czech | prazosin |
Finnish | Pratsosiini |
Russian | PRAZOZIN, ADVERZUTEN, FURAZOZIN, PRATSIOL, АДВЕРЗУТЕН, ПРАЗОЗИН, ПРАТСИОЛ, ФУРАЗОЗИН |
Japanese | プラゾシン, 塩酸プラゾシン, フラゾシン |
Italian | Furazosina, Prazosina |
Spanish | prazosina (producto), prazosín (producto), furazosín, furazosina, furazosín (producto), furazosina (sustancia), prazosina (sustancia), prazosina, prazosín, Furazosina, Prazosina |
Polish | Prazosyna |
French | Prazosine |
German | Furazosin, Prazosin |
Portuguese | Furazosin, Prazosina |
Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Terazosin (C0076107) |
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Definition (NCI_NCI-GLOSS) | A drug used to treat urinary problems caused by an enlarged prostate. It is also used to treat high blood pressure and is being studied in the treatment of other conditions. Terazosin relaxes muscle tissue in blood vessels and in the prostate. It is a type of alpha blocker. |
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | C041226 |
SnomedCT | 349914007, 129484001, 387068008 |
LNC | LP101133-9, MTHU036183 |
English | terazosin, Terazosin, Terazosin [Chemical/Ingredient], terazosine, TERAZOSIN, Terazosin (product), Terazosin (substance) |
Spanish | terazosina (producto), terazosina (sustancia), terazosina |
Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Doxazosin (C0114873) |
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Definition (MSH) | A prazosin-related compound that is a selective alpha-1-adrenergic blocker. |
Definition (NCI) | A quinazoline with antihypertensive and antineoplastic properties. Doxazosin is an alpha-adrenergic antagonist that selectively inhibits alpha-1 adrenergic receptors. Blockages of the alpha-1 adrenergic action on the vascular smooth muscles lead to a decrease in vascular resistance and antihypertensive activity. This agent also shows high affinity to alpha-1c adrenoceptor, the predominant functional type in the prostate, which may partially attribute to its effect in treatment of benign prostatic hyperplasia. Furthermore, doxazosin induces apoptosis in prostate cancer cells mediated through inhibition of protein kinase B (PKB)/Akt-signaling death receptor regulatory pathway. |
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | D017292 |
SnomedCT | 108556006, 372508002 |
LNC | LP171393-4 |
English | Doxazosin, Piperazine, 1-(4-amino-6,7-dimethoxy-2-quinazolinyl)-4-((2,3-dihydro-1,4-benzodioxin-2-yl)carbonyl)-, Doxazosin [Chemical/Ingredient], doxazosin (medication), alpha blockers doxazosin, doxazosin, DOXAZOSIN, Doxazosin (product), Doxazosin (substance) |
Swedish | Doxazosin |
Czech | doxazosin |
Finnish | Doksatsosiini |
Russian | DOKSAZOZIN, ДОКСАЗОЗИН |
Japanese | ドキサゾシン, ドキサゾシンメシレート, メシル酸ドキサゾシン |
Spanish | Doxazosina, Doxazosin, doxazosina (producto), doxazosina (sustancia), doxazosina |
Portuguese | Doxazossina, Doxazosin, Doxazosina |
Polish | Doksazosyna, Metylosulfonian doksazosyny |
French | Doxazosine |
German | Doxazosin |
Italian | Dossazosina |
Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Minipress (C0242447) |
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Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | D011224 |
English | Pfizer Brand of Prazosin Hydrochloride, minipress, Minipress |
Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
tamsulosin (C0257343) |
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Definition (NCI_NCI-GLOSS) | A drug used to treat urinary problems caused by an enlarged prostate. Tamsulosin relaxes the muscles of the prostate and bladder, which helps the flow of urine. It is a type of alpha blocker. |
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | C088482 |
SnomedCT | 108559004, 372509005 |
LNC | LP171642-4 |
English | 5-(2-((2-(2-ethoxyphenoxy)ethyl)amino)propyl)-2-methoxybenzenesulfonamide, tamsulosin, 5-((2R)-2-(2-(2-ethoxyphenoxy)ethylamino)propyl)-2-methoxy-benzenesulfonamide, tamsulosin [Chemical/Ingredient], TAMSULOSIN, Tamsulosin, Tamsulosin (product), Tamsulosin (substance) |
Spanish | tamsulosina (producto), tamsulosina (sustancia), tamsulosina |
Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Hytrin (C0591628) |
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Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | C041226 |
English | Abbott Brand of Terazosin Hydrochloride, hytrin, hytrin bph, Hytrin, Hytrin BPH, Deflox, Flotrin, Heitrin, Hytrine |
Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Flomax (C0662903) |
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Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | C088482 |
English | Flomax, Abbott laboratories brand of tamsulosin hydrochloride, flomax |
Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Cardura (C0678136) |
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Definition (MSH) | Trade name in United States. |
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | D017292 |
English | Carduran, cardura, carduran, Cardura, Cardular, Pfizer Brand of Doxazosin Mesylate, Zoxan |
Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
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