terazosin (Rx)

Brand and Other Names:Hytrin
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

capsule

  • 1mg
  • 2mg
  • 5mg
  • 10mg

Benign Prostate Hyperplasia

Initial: 1 mg PO qHS

May gradually increase to 5 mg PO qHS; up to 20 mg/day beneficial for some

Dosing considerations

  • Give first dose and subsequent increases at bedtime to avoid syncope
  • May take with food

Hypertension

Initial: 1 mg PO qHS

Maintenance: 1-5 mg/day or q12hr; may increase to ≤20 mg/day

Dosing considerations

  • Give first dose and subsequent increases at bedtime to avoid syncope
  • May take with food

Dosing Modifications

Hepatic impairment: Use with caution

Dosage Forms & Strengths

capsule

  • 1mg
  • 2mg
  • 5mg
  • 10mg

Hypertension (Off-label)

1 mg/day PO; increase dose gradually as necessary; up to maximum of 20 mg/day

Hypertension

Initial: 0.5 mg PO qHS and titrate to response

Dosing considerations

Avoid use for hypertension; high risk of orthostatic hypotension (Beers criteria)

May cause significant orthostatic hypotension and syncope

Lower initial doses than those used for nongeriatric adults, as well as gradual adjustments, are recommended for hypertension

Give first dose and subsequent increases at bedtime to avoid syncope

Adverse effects such as dry mouth and urinary complications can be bothersome in the elderly

May take with food

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Interactions

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              Serious - Use Alternative (5)

              • lofexidine

                lofexidine, terazosin. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.

              • sildenafil

                sildenafil increases effects of terazosin by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of hypotension; separate sildenafil >25mg from alpha blocker by 4hr.

              • tamsulosin

                terazosin, tamsulosin. Either increases effects of the other by additive vasodilation. Avoid or Use Alternate Drug. Risk of hypotension.

              • vardenafil

                vardenafil increases effects of terazosin by pharmacodynamic synergism. Contraindicated. Risk of hypotension.

              • yohimbe

                yohimbe increases effects of terazosin by pharmacodynamic synergism. Contraindicated.

              Monitor Closely (92)

              • acebutolol

                terazosin and acebutolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely. Additive hypotensive effects may occur when terazosin is used in combination with acebutolol.

              • aceclofenac

                aceclofenac decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • acemetacin

                acemetacin decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • aldesleukin

                aldesleukin increases effects of terazosin by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • alfuzosin

                alfuzosin and terazosin both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • amifostine

                amifostine, terazosin. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration with blood pressure lowering agents may increase the risk and severity of hypotension associated with amifostine. When amifostine is used at chemotherapeutic doses, withhold blood pressure lowering medications for 24 hr prior to amifostine; if blood pressure lowering medication cannot be withheld, do not administer amifostine.

              • amlodipine

                terazosin and amlodipine both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • asenapine

                asenapine and terazosin both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • aspirin

                aspirin decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • aspirin rectal

                aspirin rectal decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • aspirin/citric acid/sodium bicarbonate

                aspirin/citric acid/sodium bicarbonate decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • atenolol

                terazosin and atenolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • avanafil

                avanafil increases effects of terazosin by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • benazepril

                benazepril, terazosin. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response.

              • betaxolol

                terazosin and betaxolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • bisoprolol

                terazosin and bisoprolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • bretylium

                terazosin, bretylium. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Each drug may cause hypotension.

              • captopril

                captopril, terazosin. Either increases effects of the other by Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response. Both drugs lower blood pressure. Monitor blood pressure.

              • carbidopa

                carbidopa increases effects of terazosin by pharmacodynamic synergism. Use Caution/Monitor. Therapy with carbidopa, given with or without levodopa or carbidopa-levodopa combination products, is started, dosage adjustment of the antihypertensive drug may be required.

              • carvedilol

                terazosin and carvedilol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • celecoxib

                celecoxib decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • celiprolol

                terazosin and celiprolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • choline magnesium trisalicylate

                choline magnesium trisalicylate decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • clevidipine

                terazosin and clevidipine both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • diclofenac

                diclofenac decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • diflunisal

                diflunisal decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • diltiazem

                terazosin and diltiazem both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • doxazosin

                doxazosin and terazosin both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • enalapril

                enalapril, terazosin. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response.

              • esmolol

                terazosin and esmolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely. Additive hypotensive effects may occur when terazosin is used in combination with esmolol.

              • etodolac

                etodolac decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • felodipine

                terazosin and felodipine both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • fenoprofen

                fenoprofen decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • flurbiprofen

                flurbiprofen decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • fosinopril

                fosinopril, terazosin. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response.

              • ibuprofen

                ibuprofen decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • ibuprofen IV

                ibuprofen IV decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • iloperidone

                iloperidone increases effects of terazosin by pharmacodynamic synergism. Use Caution/Monitor.

              • imidapril

                imidapril, terazosin. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response.

              • indomethacin

                indomethacin decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • isradipine

                terazosin and isradipine both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • ketoprofen

                ketoprofen decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • ketorolac

                ketorolac decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • ketorolac intranasal

                ketorolac intranasal decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • labetalol

                terazosin and labetalol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • levodopa

                levodopa increases effects of terazosin by pharmacodynamic synergism. Use Caution/Monitor. Consider decreasing dosage of antihypertensive agent.

              • lisinopril

                lisinopril, terazosin. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response.

              • lornoxicam

                lornoxicam decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • lurasidone

                lurasidone increases effects of terazosin by Other (see comment). Use Caution/Monitor. Comment: Potential for increased risk of hypotension with concurrent use. Monitor blood pressure and adjust dose of antihypertensive agent as needed.

              • maraviroc

                maraviroc, terazosin. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of orthostatic hypotension.

              • meclofenamate

                meclofenamate decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • mefenamic acid

                mefenamic acid decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • meloxicam

                meloxicam decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • methylphenidate

                methylphenidate will decrease the level or effect of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. Monitor BP.

              • metoprolol

                terazosin and metoprolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • moexipril

                moexipril, terazosin. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response.

              • moxisylyte

                moxisylyte and terazosin both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • nabumetone

                nabumetone decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • nadolol

                terazosin and nadolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • naproxen

                naproxen decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • nebivolol

                terazosin and nebivolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • nicardipine

                terazosin and nicardipine both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • nifedipine

                terazosin and nifedipine both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • nisoldipine

                terazosin and nisoldipine both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • nitroglycerin rectal

                nitroglycerin rectal, terazosin. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Observe for possible additive hypotensive effects during concomitant use. .

              • oxaprozin

                oxaprozin decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • oxymetazoline topical

                oxymetazoline topical increases and terazosin decreases sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • parecoxib

                parecoxib decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • penbutolol

                terazosin and penbutolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • perindopril

                perindopril, terazosin. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response.

              • phenoxybenzamine

                phenoxybenzamine and terazosin both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • phentolamine

                phentolamine and terazosin both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • pindolol

                terazosin and pindolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • piroxicam

                piroxicam decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • prazosin

                prazosin and terazosin both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • propranolol

                terazosin and propranolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely. Additive hypotensive effects may occur when terazosin is used in combination with propranolol.

              • pseudoephedrine

                pseudoephedrine decreases effects of terazosin by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

              • quinapril

                quinapril, terazosin. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response.

              • ramipril

                ramipril, terazosin. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response.

              • salicylates (non-asa)

                salicylates (non-asa) decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • salsalate

                salsalate decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • silodosin

                silodosin and terazosin both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • sotalol

                terazosin and sotalol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely. Additive hypotensive effects may occur when terazosin is used in combination with sotalol.

              • sulfasalazine

                sulfasalazine decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • sulindac

                sulindac decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • tadalafil

                tadalafil increases effects of terazosin by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • timolol

                terazosin and timolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • tolfenamic acid

                tolfenamic acid decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • tolmetin

                tolmetin decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • trandolapril

                trandolapril, terazosin. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Exaggerated first dose hypotensive response.

              • verapamil

                terazosin and verapamil both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              • zotepine

                terazosin and zotepine both increase anti-hypertensive channel blocking. Use Caution/Monitor.

              Minor (7)

              • brimonidine

                brimonidine increases effects of terazosin by pharmacodynamic synergism. Minor/Significance Unknown.

              • butcher's broom

                terazosin, butcher's broom. Either decreases effects of the other by Mechanism: pharmacodynamic antagonism. Minor/Significance Unknown.

              • ethanol

                terazosin, ethanol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypotension, esp. in Asian pts.

              • phenylephrine

                terazosin, phenylephrine. Either decreases effects of the other by Mechanism: pharmacodynamic antagonism. Minor/Significance Unknown.

              • phenylephrine PO

                terazosin, phenylephrine PO. Either decreases effects of the other by Mechanism: pharmacodynamic antagonism. Minor/Significance Unknown.

              • tizanidine

                tizanidine increases effects of terazosin by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypotension.

              • treprostinil

                treprostinil increases effects of terazosin by pharmacodynamic synergism. Minor/Significance Unknown.

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              Adverse Effects

              >10%

              Dizziness (10-20%)

              Asthenia (2-13%)

              1-10%

              Hypotension (3-7%)

              Rhinitis/nasal congestion (2-6%)

              Lightheadedness (3-5%)

              Somnolence (3-5%)

              Palpitation (4%)

              Nausea (2-4%)

              Edema (3%)

              Sinusitis (3%)

              Dyspnea (2-3%)

              Fatigue (2.5%)

              Headache (2.5%)

              Back pain (2.4%)

              Flulike syndrome (2.4%)

              Tachycardia (2%)

              Amblyopia (1-2%)

              Blurred vision (1-2%)

              Impotence (1-2%)

              Syncope (1%)

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              Warnings

              Contraindications

              Hypersensitivity to terazosin, other quinazolines

              Cautions

              Carcinoma of the prostate and BPH cause many of the same symptoms; these two diseases frequently co-exist; patients thought to have BPH should be examined prior to starting therapy to rule out presence of carcinoma of the prostate

              Therapy can cause marked lowering of blood pressure, especially postural hypotension, and syncope in association with first dose or first few days of therapy; a similar effect can be anticipated if therapy is interrupted for several days and then restarted; to decrease likelihood of syncope or excessive hypotension, treatment should always be initiated at a low dose (1 mg) and increased slowly; additional antihypertensive agents should be added with caution; patient should be cautioned to avoid situations, such as driving or hazardous tasks, where injury could result should syncope occur during initiation of therapy

              If syncope occurs, the patient should be placed in a recumbent position and treated supportively as necessary; there is evidence that orthostatic effect is greater, even in chronic use, shortly after dosing; the risk of the events is greatest during initial seven days of treatment, but continues at all time intervals

              While syncope is the most severe orthostatic effect, other symptoms of lowered blood pressure, such as dizziness, lightheadedness and palpitations, are more common; patients with occupations in which such events represent potential problems should be treated with particular caution

              May cause CNS depression, which may impair physical or mental abilities; use caution when performing tasks that may require mental alertness, including driving or operating heavy machinery

              May exacerbate heart failure

              Concomitant administration with PDE-5 inhibitor (eg, sildenafil) can result in additive blood pressure-lowering effects and symptomatic hypotension; initiate PDE-5 inhibitor therapy at lowest dose

              Risk of priapism (rare); because this condition can lead to permanent impotence if not promptly treated, patients must be advised about seriousness of the condition

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              Pregnancy & Lactation

              Pregnancy category: C

              Lactation: Not known if excreted into breast milk; use caution

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              Blocks postsynaptic alpha-1 receptor; alpha blockade causes arterial and venous dilation

              Selective agents cause less tachycardia than do nonselective agents

              Absorption

              Bioavailability: 90%

              Onset (hypertension): 3 hr

              Onset (benign prostate hyperplasia): 2 weeks

              Duration: 24 hr

              Peak response (benign prostate hyperplasia): 4-6 weeks

              Peak plasma time: 1 hr

              Distribution

              Protein bound: 90-94%

              Vd: 25-30 L

              Metabolism

              Metabolized extensively via hydrolysis, O-demethylation, and N-dealkylation in liver

              Metabolites: 6- and 7-O-demethyl terazosin, piperazine derivative, diamine metabolite

              Elimination

              Half-life: 9-12 hr

              Renal clearance: 9-12.5 mL/min

              Excretion: Feces (55-60%); urine (40%)

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              terazosin oral
              -
              5 mg capsule
              terazosin oral
              -
              2 mg capsule
              terazosin oral
              -
              10 mg capsule
              terazosin oral
              -
              1 mg capsule
              terazosin oral
              -
              5 mg capsule
              terazosin oral
              -
              1 mg capsule
              terazosin oral
              -
              10 mg capsule
              terazosin oral
              -
              10 mg capsule
              terazosin oral
              -
              2 mg capsule
              terazosin oral
              -
              5 mg capsule
              terazosin oral
              -
              2 mg capsule
              terazosin oral
              -
              1 mg capsule
              terazosin oral
              -
              2 mg capsule
              terazosin oral
              -
              10 mg capsule

              Copyright © 2010 First DataBank, Inc.

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              Formulary

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              Tier Description
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