What is the recommended treatment and dosage for Benign Prostatic Hyperplasia (BPH) and Hypertension using Terazosin (Hytrin)?

From the Guidelines

For treating both benign prostatic hyperplasia (BPH) and hypertension, terazosin (Hytrin) is typically started at a low dose of 1 mg at bedtime, gradually increasing to an effective dose of 5-10 mg daily. The recommended approach is to begin with 1 mg at bedtime for the first 3-7 days, then increase to 2 mg daily for another week, followed by 5 mg daily, and if needed, up to a maximum of 10 mg daily 1. This gradual titration helps minimize side effects, particularly first-dose hypotension which can cause dizziness and fainting. Taking terazosin at bedtime reduces the risk of these orthostatic effects. Patients should be aware that the full therapeutic effect for BPH symptoms may take 4-6 weeks to develop. Terazosin works by blocking alpha-1 adrenergic receptors, which relaxes smooth muscle in both the prostate and blood vessels, thereby improving urinary flow and lowering blood pressure.

Some key points to consider when using terazosin for BPH and hypertension include:

• The medication should be taken at bedtime to reduce the risk of orthostatic hypotension
• Patients should rise slowly from sitting or lying positions to minimize dizziness
• Regular follow-up appointments are important to monitor blood pressure response and urinary symptom improvement
• Common side effects include dizziness, headache, drowsiness, and nasal congestion
• Patients should avoid situations requiring alertness until they know how the medication affects them

It's also important to note that terazosin may be associated with orthostatic hypotension, especially in older adults, and should be used with caution in patients with certain medical conditions, such as heart failure or ischemic heart disease 1. Additionally, terazosin may interact with other medications, such as diuretics or beta blockers, and patients should be monitored closely for potential interactions. Overall, terazosin can be an effective treatment option for patients with BPH and hypertension, but it's essential to carefully consider the potential benefits and risks and to monitor patients closely for side effects and interactions.

From the FDA Drug Label

DOSAGE AND ADMINISTRATION If Terazosin Capsules administration is discontinued for several days, therapy should be reinstituted using the initial dosing regimen. Benign Prostatic Hyperplasia Initial Dose: 1 mg at bedtime is the starting dose for all patients, and this dose should not be exceeded as an initial dose Patients should be closely followed during initial administration in order to minimize the risk of severe hypotensive response. Subsequent Doses: The dose should be increased in a stepwise fashion to 2 mg, 5 mg, or 10 mg once daily to achieve the desired improvement of symptoms and/or flow rates. Doses of 10 mg once daily are generally required for the clinical response Therefore, treatment with 10 mg for a minimum of 4-6 weeks may be required to assess whether a beneficial response has been achieved. Hypertension The dose of Terazosin Capsules and the dose interval (12 or 24 hours) should be adjusted according to the patient's individual blood pressure response. The following is a guide to its administration: Initial Dose:1 mg at bedtime is the starting dose for all patients, and this dose should not be exceeded This initial dosing regimen should be strictly observed to minimize the potential for severe hypotensive effects. Subsequent Doses: The dose may be slowly increased to achieve the desired blood pressure response. The usual recommended dose range is 1 mg to 5 mg administered once a day; however, some patients may benefit from doses as high as 20 mg per day

The recommended treatment and dosage for Benign Prostatic Hyperplasia (BPH) using Terazosin (Hytrin) is:

• Initial dose: 1 mg at bedtime
• Subsequent doses: increased in a stepwise fashion to 2 mg, 5 mg, or 10 mg once daily
• Typical effective dose: 10 mg once daily
• Minimum treatment duration: 4-6 weeks to assess clinical response

The recommended treatment and dosage for Hypertension using Terazosin (Hytrin) is:

• Initial dose: 1 mg at bedtime
• Subsequent doses: slowly increased to achieve desired blood pressure response
• Usual recommended dose range: 1 mg to 5 mg administered once a day
• Maximum dose: 20 mg per day 2

From the Research

Treatment of Benign Prostatic Hyperplasia (BPH) and Hypertension with Terazosin

• Terazosin is a selective long-acting alpha 1 blocker used to treat symptomatic BPH and hypertension 3, 4.
• The recommended dosage of terazosin for BPH is 1-10 mg daily, titrated to maximal doses ranging between 5-20 mg 3.
• Studies have shown that terazosin is effective in improving urinary flow rates and reducing symptom scores in patients with BPH 3, 4, 5.
• Terazosin has also been shown to be effective in treating concomitant hypertension and BPH, with significant reductions in blood pressure and improvement in BPH symptoms 4.

Efficacy and Safety of Terazosin

• Terazosin has been shown to be well-tolerated and effective in long-term treatment of patients with BPH, with significant improvements in peak urinary flow rates and symptom scores 5.
• The most common adverse events associated with terazosin are dizziness, asthenia, and somnolence 5.
• Terazosin has been compared to other alpha-1 blockers, such as prazosin and tamsulosin, and has been shown to have a similar efficacy and safety profile 6.

Treatment of Hypertension in Patients with BPH

• Terazosin may be used to treat hypertension in patients with BPH, but may be associated with orthostatic hypotension, especially when used concomitantly with diuretics 7.
• Alternative treatments for hypertension in patients with BPH include low-dose diuretic therapy, calcium-entry blockers, central alpha-agonists, angiotensin-converting enzyme inhibitors, and angiotensin II receptor blockers 7.