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Alpha-1 blocker

Doxazosin

Brand names: Cardura

Adult dose

Dose: Hypertension: 1mg OD initially; titrate to 2–4mg OD (max 16mg). BPH: 1–8mg OD MR formulation
Route: Oral
Frequency: OD

Clinical pearls

  • NICE NG136: 4th-line antihypertensive (resistant HT); avoid as monotherapy first-line (ALLHAT data)
  • BAUS / NICE NG97: BPH first-line medical therapy
  • Inform ophthalmology pre-cataract surgery (IFIS risk)

Contraindications

  • Postural hypotension
  • Severe hepatic impairment (immediate-release)
  • Hypersensitivity
  • Pregnancy/breastfeeding

Side effects

  • First-dose hypotension (start at bedtime)
  • Dizziness
  • Headache
  • Oedema
  • Nasal congestion
  • Priapism (rare)
  • Intra-operative floppy iris syndrome (cataract surgery)

Interactions

  • Other antihypertensives (additive)
  • PDE5 inhibitors (hypotension — separate timing)
  • CYP3A4 inhibitors

Monitoring

  • BP (sit/stand)
  • Symptoms
  • IPSS in BPH

Reference: BNF; NICE NG136; NICE NG97; BAUS; https://bnf.nice.org.uk/drugs/doxazosin/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.