From the Guidelines
A female patient may take doxazosin to treat high blood pressure (hypertension) or to manage urinary symptoms associated with urethral obstruction, with a typical starting dose of 1 mg once daily, gradually increasing if needed to 2-8 mg daily, as recommended by the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults 1.
Key Points
- Doxazosin works by relaxing blood vessels and smooth muscle in the bladder neck and prostate (though females don't have prostates, the medication's effect on urethral smooth muscle can still help with certain urinary symptoms) 1.
- As an alpha-1 adrenergic blocker, doxazosin prevents norepinephrine from binding to receptors, causing vasodilation and reducing peripheral resistance 1.
- Common side effects include dizziness, headache, and orthostatic hypotension, especially when starting treatment, and patients should take the first dose at bedtime and rise slowly from sitting or lying positions to minimize dizziness 1.
- While less commonly prescribed for women than men, doxazosin can be effective for female patients with certain urinary conditions or as part of a hypertension treatment regimen, with the combination of an alpha-adrenergic receptor blocker and a 5 alpha-reductase inhibitor being an appropriate and effective treatment for patients with LUTS associated with demonstrable prostatic enlargement 1.
Considerations
- The combination of doxazosin and finasteride has been found to be more effective in relieving and preventing the progression of symptoms than alpha-blocker monotherapy in a 5-year study 1.
- The safety of specific combinations other than finasteride plus doxazosin, terazosin, and alfuzosin has not been assessed, and the overall probability of risks and their relative reduction over time by therapy must be weighed against the cost of combination therapy in an individual patient 1.
From the Research
Indications for Doxazosin in Female Patients
- Doxazosin, an alpha-blocker, is primarily used to treat hypertension and benign prostatic hyperplasia in men 2, 3.
- However, there is evidence to suggest that doxazosin may be prescribed to female patients for the treatment of hypertension 4, 5, 6.
- A study published in the British Journal of Clinical Pharmacology found that female patients taking alpha-adrenoceptor blockers, including doxazosin, had a higher prevalence of urinary incontinence compared to those taking other medications 4.
- Despite this potential side effect, doxazosin may still be prescribed to female patients with hypertension, particularly if they have certain comorbidities or are unable to tolerate other antihypertensive medications 5, 6.
Potential Benefits and Risks
- The use of doxazosin in female patients may be associated with a higher risk of urinary incontinence, which can be a distressing side effect 4.
- However, doxazosin has been shown to be an effective antihypertensive agent, with a favorable impact on blood pressure and lipid profiles 2, 3.
- Female patients taking doxazosin should be closely monitored for potential side effects, including urinary incontinence, and alternative treatments should be considered if necessary 4, 5.