Arterial hypertension. Symptomatic treatment of benign prostatic hyperplasia.
Composition:
1 tabl sustained release contains 4 mg of Doxazosin as doxazosin mesylate.
Action:
A selective and competitive antagonist of postsynaptic α receptors1adrenergic. Doxazosin reduces blood pressure by reducing peripheral vascular resistance. After a single daily dose, a clinically significant reduction in blood pressure persists for 24 hours. It reduces triglycerides and total cholesterol and increases the ratio of HDL to total cholesterol in the blood, causes regression of left ventricular hypertrophy, inhibits platelet aggregation and increases the activity of tissue plasminogen activator. patients with impaired insulin sensitivity increases the sensitivity of tissues to insulin. In patients with benign prostatic hyperplasia, it improves the results of urodynamic tests and reduces the symptoms of dysarthria. It blocks α receptors1-adrenergic located in the smooth muscles of the body and the prostate bag and in the bladder neck. After oral administration, doxazosin is well absorbed from the gastrointestinal tract, reaching a maximum concentration in the blood after about 6-8 hours. It binds to plasma proteins in about 98%. It is metabolized in the liver to inactive metabolites. Less than 5% of the dose is excreted unchanged. T0,5 is 22 hours.
Contraindications:
Hypersensitivity to quinazolines (eg prazosin, terazosin, doxazosin) and to other components of the preparation. Orthostatic hypotension. Benign prostatic hyperplasia with stasis in the upper urinary tract, chronic urinary tract infections or urinary calculi. Gastrointestinal obstruction in the history of the gastrointestinal tract, esophageal obstruction or any degree of narrowing of the gastrointestinal tract. Breast-feeding (only hypertension in the indication). Hypotension (only in the indication of benign prostatic hyperplasia). Doxazosin monotherapy is contraindicated in patients with overflow incontinence, anuria or progressive renal failure.
Precautions:
Caution in patients with pulmonary edema due to aortic or mitral valve stenosis, heart failure with a large cardiac output, right heart failure due to pulmonary embolism or pericardial fluid, left ventricular failure with low filling pressure. It should be used with caution in patients with known hepatic impairment. Due to lack of clinical experience in patients with severe hepatic impairment, it is not recommended to use this medicine in this group. Concomitant administration of type 5 phosphodiesterase inhibitors (eg Sildenafil, tadalafil, vardenafil) and doxazosin may result in symptomatic hypotension in some patients. In order to minimize the risk of developing orthostatic hypotension, the patient should be stabilized with an alpha-blocker prior to the initiation of PDE-5 inhibitors. In some patients during or after treatment with Doxazosin, the occurrence of an affective flaccid syndrome (IFIS, a small pupil syndrome) was observed during surgical treatment of cataracts. IFIS may lead to increased complications in the course of cataract surgery, therefore, before surgery, the ophthalmologist should be informed about the use of the drug in the past or now1-adrenolitycznego. Doxazosin is not recommended in children and adolescents due to lack of clinical experience.
Pregnancy and lactation:
The medicine can be used during pregnancy only if the potential benefit of the use outweighs the risk. Animal studies did not show any teratogenic effects, however, reduced fetal survival was observed at high doses. The drug is contraindicated for use during breastfeeding (doxazosin accumulates in the milk of lactating rats).
Spontaneous hypertension: adults: usually 4 mg once a day, if necessary, the dose may be increased up to a maximum dose of 8 mg once a day; time to achieve the optimal effect can be up to 4 weeks. In the treatment of hypertension, the preparation can be used as monotherapy or combination therapy (eg with a thiazide diuretic, β-adrenergic antagonist, Calcium antagonist or ACE inhibitor).Symptomatic treatment of benign prostatic hyperplasia: adults: usually 4 mg once a day, if necessary, the dose can be increased to 8 mg once a day. No dosage adjustment is necessary in patients with impaired renal function or in elderly patients. The tablets should be swallowed whole, with or without water, with water.
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