Drug Interaction:
Antiadrenergic agents ( Peripherally acting )include-
Reserpine, Guanithidine monosulphate, Guandrel sulfate, ( Alpha-1- blockers), Prazosin,Terazosin, Doxazosin, Tamsulosin, Silodosin, Alfuzosin Hcl
Refer - Prazosin
Orthostatic hypotension potentiated by beta-blockers, calcium channel blockers,diuretics. Useful combination with antihypertensives.
Indication:
Hypertension
Antiadrenergic agents ( Peripherally acting )include-
Reserpine, Guanithidine monosulphate, Guandrel sulfate, ( Alpha-1- blockers), Prazosin,Terazosin, Doxazosin, Tamsulosin, Silodosin, Alfuzosin Hcl
Refer - Prazosin
New Drugs Approved by (DCI) Drug Controller GENERAL - India For Marketing (Ref- IDMA Publication)
Name of Drug Indication Date of Approval
Terazosin Hcl Anti-hypertensive January 1995
Adverse Reaction:
Adverse Reactions-
Alpha- 1 - adrenergic Blocker Adverse Reactions
TERAZOSIN-
CARDIOVASCULAR - Palpitations 4% , Postural hypotenson 1%,
Tachycardia 2 % Arrhythmia >1%,
Vasodilation > 1%
CNS- Dizziness 20% Asthenia 11%.
Somnolence 5%, Paresthesia 3%
Nervousness 2%, Depression 0.3%
DERMATOLOGIC - Pruritus > 1%, Rash > 1%, Sweating > 1%
GI - Nausea 4% , Vomiting >1% Dry mouth > 1%
Diarrhoea > 1% Constipation> 1%
Abdominal discomfort >1% Flatulence > 1%
Dyspepsia > 1%
GU- Impotence 1% Urinary frequency >1%
Incontinence > 1%
MUSCULOSKELETAL - Shoulder neck/back extremity pain 4%
Arthiritis, joint disoder muscle pain > 1%
Arthalgia > 1%
RESPIRATORY - Nasal congestion 6% Dyspnea 3%
Sinusitis 3% Epistaxis > 1%
SPECIAL SENSES- Blurred vision 2% Conjuntivitis >1%
Abnornal vision > 1% Tinnitus > 1%
MISCELLANEOUS - Headache 16% Peripheral edema 6%
Edema 1% Fever > 1%
Contra-Indications:
Hypersens.
Special precautions:
Elderly,pregnancy,lactation,
syncope and first dose effect,
prostatic cancer(may be confused with BHP),orthostatic hypotension.
Dosages/ Overdosage Etc:
Indications:
Hypertension
Dosage:
Adjust dose and dosage interval(12 to 24 hours) individually. Initial- 1 mg at bed time for all patients.
Do not exceed this dose.
Subsequent doses- recommended dose is 1 to 5 mg daily. Some patients may benefit from doses as high as 20 mg/day.
Monitor blood pressure at the end of dosing interval to be sure that control is maintained.
Other Information:
EVIDENCE BASED MEDICINE
Management of Benign Prostatic Hypertrophy (BPH)
Comparative effectiveness of various interventions
Beneficial
1. Aplha blockers (parzosin, alfuzosin, indoramin, terazosin, doxazosin,tamsulosin)
2. 5-alpha -reductase inhibitors (e.g. finastreride)
3. Transureythral resection (TURP)
4. Transurethral microwave thermotherapy (TUMT)
5. Trnasurethral needle ablation (TUNA)
Unknown effectiveness
1. TURP versus less invasive techniques
KEY POINTS
1. Randomised controlled trials (RCTs) have found that both alpha-blockers and 5-alpha-reductase-inhibitors are more effective than placebo in improving lower urinary tract symptoms in men with BPH.
2. One trial found that alpha-blockers (e.g.prazosin ) were more effective than 5-alpha- reductase inhibitors (finasteride) in men not selected for having large prostrates.
3. Neither drug has been compared directly with surgical treatment
4. There is limited evidence from one trial that TURP is more effective than watchful waiting in improving symptoms and reducing complications, and does not increase the risk of ercetile dysfunction or incontinuence.
5. TURP has not yet been adequately compared with medical treatments or with newer less invasive techniques.
6. TUMT is more effective than sham treatment at reducing symptoms. There is no difference beween TURP and TUMT with regard to short term relief
7. One trial found that TURP was more effective than TUNA in men with BPH.
Patient Information:
Refer - Prazosin
Ref - USP PDI Vol II 17th Edition (1997)
TERAZOSIN - SYSTEMIC
1.Allergies-
Tell your doctor if you have ever had any unusual or allergic reaction to
Terazosin, prazosin, or doxazosin. Also tell your healthcare
care professional if you are allergic to any other substances such
as foods. preservatives or dyes.
2.Pregnancy-
Studies have not been done in humans. However, studies in animals
given many times the highest human dose have not shown to cause
birth defects.However, these studies have shown a decrease in successful
pregnancies.
3. Breast-feeding-
It is not known whether terazosin passes into breast milk. Although most
medicines pass into breast milk in small amounts,many of them may be
used safely while breast-feeding.Mothers who are taking this medicine
and who wish to breast feed should discuss this with their doctor.
4.Children-
Studies of this medicine has been done only in adult patients and there is
no specific information comparing terazosin in children with use in other
age groups.
5.Older adults-
Dizziness, lightheadeness or fainting (especially when getting up from
lying or sitting position) may be more likely to occur in the elderly, who
are more sensitive to the effects of terazosin.
6. Other medicines-
Tell your doctor if you are using any other prescription or
non-prescription (Over-the counter) OTC medicine.
7. Other medical problems-
The presence of other medical problems may affect the use of terazosin.
Make sure you tell your doctor if you have any other medical problems
especially-
Angina (chest pain) terazosin may make this condition worse
Heart disease (severe) - terazosin may make this condition
worse
Kidney disease- possible increased sensitivity to the effects of
terazosin
Pharmacology/ Pharmacokinetics:
Antiadrenergic agents ( Peripherally acting )include-
Reserpine, Guanithidine monosulphate, Guandrel sulfate, ( Alpha-1- blockers), Prazosin,Terazosin, Doxazosin, Tamsulosin, Silodosin, Alfuzosin Hcl
Refer - Prazosin
Interaction with Food:
Not available
Pregnancy and lactation:
Contraindicated for use during pregnancy and lactation