PRAZOSIN

brands

Class

• Alpha 1 adrenergic blocker

PRAZOSIN commonly prescribed for

(Bold for FDA approved)

How PRAZOSIN works

• Blocks alpha 1 adrenergic receptors to reduce noradrenergic hyperactivation

• Stimulation of central noradrenergic receptors during sleep may activate traumatic memories, so blocking this activation may reduce nightmares

How long until PRAZOSIN works

• Within a few days to a few weeks

Notable Side Effects

• Dizziness, lightheadedness, headache, fatigue, blurred vision

• Nausea

Life Threatening Side Effects

• Syncope with sudden loss of consciousness

weight gain

unusual

sedation

not usual

What to do about PRAZOSIN side effects

• Lower the dose

• Wait

• Wait

• Wait

• In a few weeks, switch to another agent

usual dosage range

• 1–16 mg/day, generally in divided doses

Dosage Forms

• Capsule 1 mg, 2 mg, 5 mg

long term use

• Has not been evaluated in controlled studies

• Nightmares may return if prazosin is stopped

habit forming

• No

Renal Impairment

• Use with caution in patients with severe impairment

• May require lower dose

Hepatic Impairment

• Use with caution

Cardiac Impairment

• Use with caution in patients who are predisposed to hypotensive or syncopal episodes

Elderly

• Some patients may tolerate lower doses better

• Higher risk of orthostatic hypotension and syncope

Children and Adolescents

• Safety and efficacy have not been established

Pregnancy

• Effective June 30, 2015, the FDA requires changes to the content and format of pregnancy and lactation information in prescription drug labels, including the elimination of the pregnancy letter categories; the Pregnancy and Lactation Labeling Rule (PLLR or final rule) applies only to prescription drugs and will be phased in gradually for drugs approved on or after June 30, 2001

• Controlled studies have not been conducted in pregnant women

• Prazosin has been used alone or in combination with other hypotensive agents in severe hypertension of pregnancy, with no fetal or neonatal abnormalities reported

• Prazosin should be used during pregnancy only if the potential benefits justify the potential risks to the mother and fetus

Breast Feeding

• Some drug is present in breast milk

• If child becomes irritable or sedated, breast feeding or drug may need to be discontinued

• Must weigh benefits of breast feeding with risks and benefits of treatment versus nontreatment to both the infant and the mother