Terazosin

Abstract

Terazosin selectively antagonises alpha 1-adrenoceptor-mediated contraction of the prostate, prostatic capsule, proximal urethra and bladder base, and consequently reduces urethral pressure, bladder outlet resistance and urinary symptoms associated with symptomatic benign prostatic hyperplasia. The efficacy of terazosin is reflected in increases in peak urinary flow rate, and reductions in obstructive and irritative symptom scores compared with placebo, and reductions in residual urinary volume from baseline. Clinical improvements begin to occur within 2 weeks and have been sustained for up to 2 years. The most marked treatment effects tend to occur in patients with more severe pretreatment urinary flow abnormalities. The relatively long duration of action of terazosin, allowing once-daily administration, offers a potential clinical advantage over other alpha 1-adrenoceptor antagonists although formal compliance studies have not been reported. Terazosin is generally well tolerated, but caution is recommended at treatment initiation and when dosage adjustments are made due to an increased risk of postural hypotension and related adverse effects at these times; such a risk has also been observed with several other alpha 1-adrenoceptor antagonists. Although publication of clinical trial results with terazosin is still evolving, this drug shows promise in the treatment of patients with mild to moderate symptomatic benign prostatic hyperplasia for whom surgery is not absolutely indicated. Terazosin also shows promise as a nonsurgical treatment alternative in patients with severe symptoms who are unfit for surgery and also in those who are on long waiting lists for surgery.

Adrenergic Blockade in Diabetic and Uninephrectomized Rats: Effects on Renal Size and on Renal and Urinary Contents of Epidermal Growth Factor

“…Prazosin and propranolol were suspended in 0.9% saline and administered subcutaneously twice daily as a bolus of 0.5 ml from day 0 to day 21. The dosages used were based on previous data [17, 26, 27]. Because of the relatively high toxicity of the propranolol treatment in the diabetic rats, the procedure was repeated a second time in this group in order to obtain 8 animals in each of the experimental diabetic groups.…”

Who Should Be Treated and How? Evidence-Based Medicine in Symptomatic BPH

“…Conventional α 1 -blockers (quinazoline derivatives such as terazosin [131], doxazosin [132, 133]and alfuzosin [134]) now also used to treat LUTS were originally developed to treat hypertension. For terazosin and doxazosin, the same doses are used to treat both LUTS and hypertension.…”

Management of Benign Prostate Hyperplasia: An Overview of α-Adrenergic Antagonist

“…Doses of 10 mg/d may be required for maximal effect in BPH. 42) Terazosin therapy was also found to increase peak and average flow rates without affecting voided or residual volume. Most adverse events were mild or moderate.…”