Doxazosin
CARDURA
Pronunciation: dox-AY-zoe-sin (kar-DOOR-a)
“Carder, Dox A’s or sin”
Polka dots on pink → α1 blocker → syncope if titrated too quickly (hit the floor)
What it isAlpha-1 antagonist; benign prostatic hyperplasia and resistant hypertension.
Why this oneWorse heart-failure outcomes than chlorthalidone ended its first-line hypertension role; BPH is now the more defensible use.
What limits itFirst-dose orthostatic hypotension — start at night. Nonuroselective blockade causes more hypotension than tamsulosin.
Doxazosin prescription history
Animated chart of estimated U.S. prescriptions per year, BPH meds (1987–2026). Doxazosin enters in 1991 (estimated).
FDA-approved for
- hypertension (1990)
- BPH (1995)
Off-label
- ureteral stone passage
- PTSD nightmares
Principal riskFirst-dose orthostatic hypotension
Classes and tags
Clinical profile
Legacy pregnancy categoryUnknown / historical label unavailable
Defining liabilityGenerally tolerated at therapeutic doses; clinically important risks are agent-specific and increase with interactions or organ impairment.
FDA label
Read the full label on DailyMed ↗
NO BOXED WARNINGS
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Benign prostatic hyperplasia | Adults | 1 mg QD | 2–8 mg QD | 8 mg QD |
| Hypertension | Adults | 1 mg QD | titrate to effect | 16 mg QD |
Titration BPH: increase at 1–2 week intervals.
Renal Undefined
Hepatic Not recommended in severe (Child-Pugh C); monitor BP/hypotension in mild–moderate (A/B)
Instructions
- Monitor blood pressure for ≥6 h after the initial dose and each dose increase.
- If discontinued for several days, restart using the initial dosing regimen.
Available strengths
- tab 1, 2, 4, 8 mg
- ER tab 4, 8 mg
Contraindications
- Hypersensitivity to quinazolines (e.g., prazosin, terazosin)
Cautions
- Postural hypotension with/without syncope, esp. after first dose or dose increase; additive with PDE-5 inhibitors
- Intraoperative floppy iris syndrome during cataract surgery
- Screen for prostate cancer before/during BPH treatment
Adverse reactions
- Fatigue
- Malaise
- Hypotension
- Dizziness
Pregnancy Limited data insufficient to assess risk; untreated hypertension carries maternal risk
Lactation Undefined
Cost
Generic entry2000
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Memory aids: interaction avatars
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Self-check
- Why start doxazosin at night?
First-dose orthostatic hypotension. - What outcome ended its first-line hypertension role?
Worse heart-failure outcomes than chlorthalidone.