Doxazosin was patented in 1977 and came into medical use in 1988.[4] It is available as ageneric medication.[3] In 2023, it was the 180th most commonly prescribed medication in the United States, with more than 2million prescriptions.[5][6]
Doxazosin is considered to be effective in reducing urinary symptom scores and improving peak urinary flow in men with benign prostatic hyperplasia.[10] The bladder neck is densely packed with alpha-1 receptors.
Sympatholytic drugs, includingprazosin and doxazosin, are used for nightmares and flashbacks in posttraumatic stress disorder (PTSD). Doxazosin is very well tolerated for this constellation of symptoms. Given its long half-life, doxazosin lasts much longer than prazosin. While prazosin is dosed up to 4 times daily, doxazosin is generally dosed only once daily (at night). Both are alpha-1 antagonists. Other sympatholytic drugs includeclonidine andguanfacine, which are alpha-2 agonists; they are not in the same exact class as doxazosin andprazosin.[citation needed]
TheAntihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) study stopped its arm of the trial looking at alpha blockers, because doxazosin was less effective than a simplediuretic, and because patients on doxazosin had a 25% higher rate ofcardiovascular disease and twice the rate ofcongestive heart failure as patients on diuretics.[13] Pfizer, aware of the results before publication, launched a marketing campaign in early 2000, and sales were largely unaffected, despite the dangers highlighted by the study.[14][15] The decision to stop the trial was controversial because the higher rate of heart failure (HF) in the doxazosin group could have been caused by misdiagnosis due to fluid retention from the medication, or because patients with existing HF stopped their diuretic treatment to switch to doxazosin. However, in the later ASCOT trial, where doxazosin was used as a third-line treatment, there was no increase in HF risk.[16]
^Mazza A, Armigliato M, Marzola MC, Schiavon L, Montemurro D, Vescovo G, et al. (April 2014). "Anti-hypertensive treatment in pheochromocytoma and paraganglioma: current management and therapeutic features".Endocrine.45 (3):469–478.doi:10.1007/s12020-013-0007-y.PMID23817839.S2CID25504151.
^Yuan J, Liu Y, Yang Z, Qin X, Yang K, Mao C (March 2013). "The efficacy and safety of alpha-1 blockers for benign prostatic hyperplasia: an overview of 15 systematic reviews".Current Medical Research and Opinion.29 (3):279–287.doi:10.1185/03007995.2013.766594.PMID23323875.S2CID26341029.
^Davey MJ (August 1989). "Pharmacologic basis for the use of doxazosin in the treatment of essential hypertension".Am J Med.87 (2A):36S–44S.doi:10.1016/0002-9343(89)90112-5.PMID2569823.
^Mancia G, Kreutz R, Brunström M, Burnier M, Grassi G, Januszewicz A, et al. (December 2023). "2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension: Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA)".Journal of Hypertension.41 (12):1874–2071.doi:10.1097/HJH.0000000000003480.hdl:11379/603005.PMID37345492.
