Prazosin
MINIPRESS
What it isAlpha-1 antagonist; hypertension and off-label treatment of PTSD-related nightmares.
Why this oneCNS penetration and specific use for trauma nightmares distinguish it from uroselective alpha blockers.
What limits itFirst-dose orthostatic syncope is the practical hazard; start low at bedtime, and remember its short action for blood-pressure use.
FDA-approved for
- hypertension (1976)
Off-label
- PTSD nightmares
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Hypertension | Adults | 1 mg BID–TID | 6–15 mg/day in divided doses | 20 mg/day (occasionally up to 40 mg/day) |
Renal Undefined
Hepatic Undefined
First-dose orthostatic hypotension/syncope — start low and titrate slowly
Instructions
- Give first dose at bedtime (first-dose syncope / orthostatic hypotension risk)
- When adding a diuretic or other antihypertensive, reduce to 1–2 mg TID and re-titrate
- Initiate PDE-5 inhibitors at lowest dose (additive hypotension)
Cautions
- First-dose orthostatic hypotension / syncope
- Priapism
Adverse reactions
- Dizziness
- Headache
- Drowsiness
- Lack of energy
- Weakness
- Palpitations
- Nausea
Pregnancy Undefined
Lactation Undefined
NO BOXED WARNINGS
Principal riskFirst-dose orthostatic hypotension
Cost, est. cash$5–$150/month
Generic entry1988
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.
Mechanism of action: Prazosin ballicule
Open Prazosin in the interactive console ↗
Memory aids: mascots and interaction avatars
Polka dots on pink → α1 blocker → syncope if titrated too quickly (hit the floor)
used off-label as treatment for PTSD nightmares
