What is terazosin (alpha blocker) used to treat?

Terazosin: Uses and Indications

Terazosin is primarily used to treat benign prostatic hyperplasia (BPH) and hypertension, working by relaxing blood vessels and prostate muscles to improve urine flow and lower blood pressure. 1

Treatment of Benign Prostatic Hyperplasia (BPH)

Mechanism of Action

• Terazosin is an alpha-1 adrenergic receptor antagonist (alpha blocker) that:
  • Relaxes smooth muscles in the prostate and bladder neck
  • Reduces bladder outlet obstruction
  • Decreases urethral resistance 2
  • Improves urinary flow without changing prostate size 1

Efficacy for BPH

• Provides rapid symptom relief with approximately 70% of patients experiencing:
  • Increased urinary flow
  • Improved BPH symptoms 1
  • Clinical improvements beginning within 2 weeks 3
  • Sustained benefits for up to 2 years 3

Measurable Benefits

• Increases peak urinary flow rate
• Reduces obstructive and irritative symptom scores
• Decreases residual urinary volume 3
• Improves International Prostate Symptom Score (IPSS) 4
• Most effective in patients with more severe pretreatment urinary flow abnormalities 3

Treatment of Hypertension

Antihypertensive Effects

• Relaxes blood vessels allowing easier blood flow
• Can be used alone or in combination with other antihypertensive agents:
  • Diuretics
  • Beta-blockers 1
• Produces clinically significant blood pressure reductions in hypertensive patients 5
• Does not cause clinically significant blood pressure changes in normotensive patients 5

Dosing and Administration

• Once-daily dosing (advantage over some other alpha blockers)
• Initial dose typically 1mg, with gradual titration upward
• Maintenance doses of 5-10mg daily are common 5
• First dose should be taken at bedtime to minimize risk of postural hypotension 6

Important Considerations

Potential Side Effects

• Most common adverse effects:
  • Dizziness
  • Orthostatic hypotension (especially during initiation)
  • Headache
  • Asthenia (weakness)
  • Nasal congestion 6

Cautions

• Risk of first-dose syncope (fainting)
• Increased risk of postural hypotension during:
  • Treatment initiation
  • Dosage adjustments 3
• Patients should avoid situations where injury could result if syncope occurs 7

Comparative Efficacy with Other Alpha Blockers

• The American Urological Association considers alfuzosin, doxazosin, tamsulosin, and terazosin to have equal clinical effectiveness for BPH 2
• All produce approximately 4-6 point improvement in AUA Symptom Index 2
• Tamsulosin may have fewer cardiovascular side effects compared to terazosin 7

Special Populations

Patients with Both BPH and Hypertension

• Terazosin offers the advantage of treating both conditions simultaneously 8
• In patients with both conditions, terazosin has shown:
  • 55% reduction in overall BPH symptom scores
  • 57% reduction in obstructive symptom scores
  • 54% reduction in irritative symptom scores
  • Significant blood pressure reductions 8

Monitoring and Follow-up

• Patients should notice symptom improvement within 2-4 weeks of starting treatment 1
• Regular follow-up is recommended to assess efficacy and monitor for side effects

Terazosin remains a valuable option for treating BPH and hypertension, particularly in patients who have both conditions simultaneously, though newer alpha blockers with potentially better side effect profiles are now available.