Examples:
Non-selective: terazosin, doxazosin, prazosin
Prostate-selective: tamsulosin, silodosin, alfuzosin
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Indication:
-Benign prostatic hypertrophy
-Hypertension (non-selective ones, second-line)
-Nightmares (prazosin)
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Dosing:
-most agents can be dosed once daily
-non-selective ones taken at bedtime to reduce orthostatic hypotension
-alfuzosin and silodosin taking after a meal
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Adverse Effects:
-drowsiness
-dizziness, postural hypotension (especially non-selective ones)
-nasal congestion
-priapism
-rare: intraoperative floppy iris syndrome
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Drug Interactions:
-antihypertensives: additive hypotension or dizziness
-PDE5 inhibitors such as sildenafil, vardenafil, tadalafil: additive hypotension
-most are metabolized through CYP 3A4, so caution with strong inhibitors