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Doxazosin (By mouth)

Treats problems with urination caused by an enlarged prostate (benign prostatic hyperplasia or BPH). Also used alone or in combination with other medicines to treat high blood pressure. This medicine is an alpha-blocker.

What works?

Learn more about the effects of these drugs. The most reliable research is summed up for you in our featured article.

Doxazosin belongs to the general class of medicines called antihypertensives. It is used to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidneyRead more
Brand names include
Cardura, Cardura XL
Drug classes About this
Antihypertensive, Benign Prostatic Hypertrophy Agent, Cardiovascular Agent

What works? Research summarized

Evidence reviews

Doxazosin in the treatment of benign prostatic hypertrophy: an update

We evaluated the efficacy and safety of alpha 1--blocker doxazosin for treatment of lower urinary tract symptoms (LUTS) compatible with benign prostatic hypertrophy (BPH). Fourteen randomized controlled trials enrolled 6261 men, average age 64 years, who had moderately severe LUTS and flow impairment. Compared with baseline measures and placebo effect, doxazosin resulted in a statistically significant improvement in both LUTS and flow. However, when compared with placebo, the average magnitude of symptom improvement (International Prostate Symptom Score [IPSS] improvement < 3 points) typically did not achieve a level detectable by patients. Combined doxazosin and finasteride therapy improved LUTS and reduced the risk of overall clinical progression of BPH compared to each drug separately in men followed over 4 years. Reported mean changes from baseline in the IPSS were -7.4, -6.6, -5.6, and -4.9 points for combination therapy, doxazosin, finasteride, and placebo, respectively. Combination therapy reduced the need for invasive treatment for BPH and the risk of long-term urinary retention. The absolute reductions compared with placebo were less than 4% and primarily seen in men with prostate gland volume > 40 mL or PSA levels > 4 ng/mL. Efficacy was comparable with other alpha 1--blockers. Withdrawals from treatment for any cause were comparable to placebo. Dizziness and fatigue occurred more frequently with doxazosin compared to placebo.

Benign Prostatic Hyperplasia (BPH) Management in Primary Care: Screening and Therapy [Internet]

Benign prostatic hyperplasia (BPH) causes urinary hesitancy and intermittency, weak urine stream, nocturia, frequency, urgency, and the sensation of incomplete bladder emptying. These symptoms, collectively called “lower urinary tract symptoms,” or LUTS, can significantly reduce quality of life. Men with no symptoms or mild symptoms (AUA Symptom Index [SI] score of <7 points), and those who tolerate moderate symptoms well, may be managed without pharmacotherapy (“watchful waiting”). For those who have moderate or severe symptoms, medical treatments include alpha-1-selective adrenergic receptor (a-1-AR) antagonists, 5-alpha-reductase inhibitors (5-aRIs), or a combination therapy with one drug from each of these classes.

Drug Class Review: Direct Renin Inhibitors, Angiotensin Converting Enzyme Inhibitors, and Angiotensin II Receptor Blockers: Final Report [Internet]

The renin-angiotensin system is a complex biologic system between the heart, brain, blood vessels, and kidneys that leads to the production of biologically active agents, including angiotensin I and II and aldosterone, which act together to impact a variety of bodily functions including blood vessel tone, sodium balance, and glomerular filtration pressure. The multiple and varied effects of these agents allows the renin-angiotensin system to play a wide role in the pathology of hypertension, cardiovascular health, and renal function. Our ability to begin to intervene upon the complex cycle of hormone and other biochemical agent production within the renin-angiotensin system began with the advent of the first orally active ACE-I (angiotensin converting enzyme inhibitor), captopril, in 1981. AIIRAs (angiotensin II receptor blockers) were developed as an alternative to ACE-I, and block the interaction between angiotensin II and the angiotensin receptor. Losartan, the first commercially available AIIRA, was approved for clinical use in 1995. The goal of this report is to compare the effectiveness and harms between aliskiren and placebo and between AIIRAs and ACEIs in the treatment of diagnosed coronary heart disease, hypertension, left ventricular dysfunction, heart failure, nondiabetic chronic kidney disease, or diabetic nephropathy.

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Summaries for consumers

Fact sheet: Medications for enlarged prostate

Most men who have prostate problems either wait a while to see how their symptoms develop or take medication. Medication is often used when the symptoms are not bad enough to warrant surgery, but have become too bothersome to cope with. The man might have to get up several times a night to urinate, or constantly feel the need to urinate during the day too because his bladder will no longer empty properly. These typical symptoms of an enlarged prostate can become a real burden.

Finasteride provides relief of symptoms related to benign prostatic hyperplasia.

Finasteride, when compared to placebo and active comparators, improves long‐term urinary tract symptoms associated with benign prostatic hyperplasia.

Alpha blocker treatment for men to increase chances to have urinary catheter successfully removed

Acute urinary retention in men is a medical emergency characterised by the sudden and often painful inability to pass urine. There are many known causes including prostate obstruction (because of enlargement of the prostate or cancer), urethral strictures (a narrowing of the urethra due to scar tissue), urine infection, constipation and neurological conditions. A narrow drainage tube (urinary catheter) is temporarily inserted into the bladder through the penis to allow drainage of urine. Once the catheter is removed, some men fail to pass urine again and need to be re‐catheterised. In these men, continued use of catheters or prostate surgery are the standard treatment options. Catheters are associated with risks such as infection and can harm quality of life. Measures for increasing the rate of successful catheter removal, that is, enabling patients to urinate spontaneously again, are therefore potentially beneficial. Alpha blockers (for example tamsulosin, alfuzosin) are a group of drugs known to have positive effects on urinary symptoms such as poor urinary flow. It is believed that their relaxing effect on the prostate may also increase the chance to void again after catheter removal. This review evaluated the evidence available to support this practice.

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