Benign prostatic hyperplasia (BPH). Symptomatic treatment of micturition disorders caused by benign prostatic hyperplasia (reduction of the urine stream, feeling of incomplete emptying of the urinary bladder, nocturia, pollakiuria, painful or urgent urinary urgency). Doxazosin can be administered to patients with hypertension and to patients with normal blood pressure who have been diagnosed with prostate hyperplasia. For patients with both benign prostatic hyperplasia and hypertension, doxazosin is effective in both indications.Spontaneous hypertension. Treatment of essential hypertension. If the intended reduction can not be achieved with the monotherapy, it can be used simultaneously with other antihypertensive agents (thiazide diuretics, β-adrenergic blockers, Calcium channel blockers, ACE inhibitors). The preparation is intended for the treatment of adult patients.
A selective and competitive antagonist of postsynaptic α receptors1adrenergic. It blocks α receptors1-adrenergic localized in the smooth muscle of the stroma and the prostatic bag and around the bladder neck. In patients with benign prostatic hyperplasia, it improves the results of urodynamic tests and reduces the symptoms of dysarthria. It lowers blood pressure by reducing peripheral vascular resistance. After a single daily dose, a clinically significant reduction in blood pressure is maintained throughout the day after administration. It has a beneficial effect on the lipid profile: it significantly increases the ratio of high-density lipoprotein (HDL) to total cholesterol and decreases the concentration of triglycerides and total cholesterol in the blood. Treatment with doxazosin reduces the risk of developing ischemic heart disease, contributes to the reversal of left ventricular hypertrophy, inhibits platelet aggregation and increases the activity of tissue plasminogen activator. Doxazosin also reduces insulin resistance. Doxazosin is well absorbed after oral administration, reaching Cmax during 1-2 h. It is extensively metabolised in the liver (by demethylation and hydroxylation) to inactive metabolites. The elimination of the drug is two-phase, T0,5 in the elimination phase is 22 h. Doxazosin metabolites are excreted in faeces. Less than 5% of the administered dose is excreted unchanged.
Contraindications:
Hypersensitivity to Doxazosin, other quinazoline derivatives or any of the excipients. Postural hypotension or orthostatic hypotension. Breastfeeding period.
Precautions:
Use in children is not recommended. Particularly cautiously use in patients with known hepatic impairment; use in patients with severe hepatic impairment is not recommended. Do not use in patients with benign prostatic hyperplasia with simultaneous congestion of the upper urinary tract, chronic urinary tract infections or bladder stones. According to careful medical practice, do not use in patients with bladder overflow, anuria or progressive renal failure. It is recommended to check blood pressure at the beginning of treatment with doxazosin to reduce the possibility of orthostatic symptoms. Exercise caution in patients with severe heart disease: pulmonary edema caused by aortic stenosis or mitral stenosis, heart failure at high ejection capacity, right heart failure due to pulmonary embolism or pericardial effusion, left ventricular heart failure with low filling pressures. In patients with severe coronary disease, a rapid and significant reduction in blood pressure may exacerbate angina pectoris. Because of the risk of symptomatic hypotension, use caution in combination with a PDE-5 inhibitor.Due to the lactose content, the drug should not be used in patients with rare hereditary galactose intolerance, lactase deficiency (Lapp type) or malabsorption of Glucose and galactose.
Pregnancy and lactation:
It can only be used in pregnant women if the benefit to the mother outweighs the potential risk to the fetus. Do not use during breast-feeding.
Side effects:
Most often, orthostatic disorders (rarely manifested by weakness, primarily after the first dose, although they may also occur after increasing the dose or after a treatment break exceeding a few days) or non-specific side effects, such as dizziness, headache, excessive fatigue, malaise, vertigo, swelling, weakness, drowsiness, nausea and rhinitis. Very rare: urinary incontinence. In addition, there were other side effects for which a cause and effect relationship was not established with doxazosin: agitation, tremor, tachycardia, palpitations, chest pain, angina, myocardial infarction, cerebrovascular episodes and arrhythmias; rarely: abdominal pain, diarrhea and vomiting. There have been isolated cases of hypersensitivity reactions (skin rash, pruritus, redness, jaundice associated with elevated aminotransferases) and nasal bleeding. There have been cases of priapism.
Dosage:
Orally. Adults.Benign prostatic hyperplasia (BPH): initially 1 mg once a day. If the effect is insufficient (abnormal urodynamic results or persistent asthmatic symptoms), after 1-2 weeks the dose can be increased to 2 mg once a day, and then to 4 mg once a day. The maximum recommended dose is 8 mg / day.Spontaneous hypertension: initially 1 mg once a day. If necessary, the dose may be increased after 1-2 weeks to 2 mg once a day, then, depending on the patient's response to treatment assessed on the basis of achieved blood pressure, up to 4 mg once a day, and then up to 8 mg once per day. day. The most commonly used dose is 2-4 mg once a day. The maximum recommended dose is 16 mg / day.Special groups of patients. In patients with impaired renal function, the usual recommended dose may be used, however, the dose should be as small as possible and the dose should be increased under strict control. Doxazosin is highly bound to plasma proteins and therefore can not be removed by dialysis. In patients with impaired liver function, the drug should be used with caution; it is not recommended for patients with severe hepatic impairment. Swallow the tablet whole without chewing it with water.
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