Cardura, Cardura XL
**1. Cardura (Doxazosin)
IR: 1 mg HS, titrate slowly up to 4-8mg HS
XL: 4 mg daily with bfast; max 8 mg qday (ghost tab in stool) ***
Non-selective
Additional ADE: orthostasis/dizziness
Hytrin
**2. Hytrin (terazosin)
*** 1 mg HS; max 20 mg HS
Non-selective
Additional ADE: orthostasis/dizziness
Flomax
- Tamsulosin
- 0.4 mg daily 30 min after same meal daily; max 0.8 mg daily
- dutasteride (Jalyn)
Additional ADE: rhinitis, abnormal ejaculation
UROXATRAL
Afluzosin
* 10 mg daily after same meal each day
* CrCl<30: use with caution
CI: concurrent use with strong CYP3A4i or hepatic impairment
Do not use if risk of QT prolongation
Rapaflo
Silodosin
* 8 mg daily with meal
* CrCl 30-50: 4 mg daily
* CrCl <30: do not use
CI: CYP3A4i, hepatic or renal impairment
Additional ADE: abnormal and retrograde ejaculation
also cannot be used with strong P-gpi
Class ADE/warnings
- Orthostatic hypotension/syncompe
- intraoperative floppy iris syndrome (IFIS) in cataract surgery if currently on or previously on alpha 1 blocker
- priapism, seek medical attn if erection >4 hrs
- angina, d/c if sx of angina
ADE: dizziness, fatigue, HA, abnormal ejaculation, fluid retention
Drug interactions (alpha blockers)
- Use with caution when co-administered with PDE5i due to additive hypotensive effects (don’t use with tadalafil)
Proscar
- Finasteride
- 5 mg daily
- Propecia - for alopecia (1 mg daily)
Avodart
- Dutasteride
- 0.5 mg daily
- Swallow whole, do not chew or open contents (oropharyngeal irritation)
Class warnings/CI/ADE for 5 alpha reductase inhibitors
- CI: women of child-bearing age, pregnancy, children (NIOSH list)
- may increase risk of high-grade prostate CA
- ADE: impotence, low libido, ejaculation issues, breast enlargement/tenderness
- Tx for 6 months or longer may be req for max efficacy
