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PEBC: What You Need to Know: Alpha Blockers


Non-selective: terazosin, doxazosin, prazosin

Prostate-selective: tamsulosin, silodosin, alfuzosin



-Benign prostatic hypertrophy

-Hypertension (non-selective ones, second-line)

-Nightmares (prazosin)



-most agents can be dosed once daily

-non-selective ones taken at bedtime to reduce orthostatic hypotension

-alfuzosin and silodosin taking after a meal


Adverse Effects:


-dizziness, postural hypotension (especially non-selective ones)

-nasal congestion


-rare: intraoperative floppy iris syndrome


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

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