terazosin hydrochloride

(ter ay' zoe sin)

Hytrin

Pregnancy Category C

Drug classes
Antihypertensive
Alpha-adrenergic blocker

Therapeutic actions
Selectively blocks postsynaptic alpha1-adrenergic receptors, decreasing sympathetic tone
on the vasculature, dilating arterioles and veins, and lowering supine and standing BP;
unlike conventional alpha-adrenergic blocking agents (eg, phentolamine), it does not also
block alpha2 presynaptic receptors, does not cause reflex tachycardia.

Indications
• Treatment of hypertension alone or in combination with other drugs
• Treatment of symptomatic BPH

Contraindications and cautions

• Contraindicated with hypersensitivity to terazosin, lactation.
• Use cautiously with CHF, renal failure, pregnancy, other antihypertensives.

Available forms
Capsules—1, 2, 5, 10 mg; tablets—1, 2, 5, 10 mg

Dosages
ADULTS
Adjust dose and dosing interval (12 or 24 hr) individually.
• Hypertension: Initial dose, 1 mg PO hs. Do not exceed 1 mg; strictly adhere to
this regimen to avoid severe hypotensive reactions. Slowly increase dose to
achieve desired BP response. Usual range: 1–5 mg PO daily. Up to 20 mg/day has
been beneficial. Monitor BP 2–3 hr after dosing to determine maximum effect. If
response is diminished after 24 hr, consider increasing dosage. If drug is not taken
for several days, restart with initial 1-mg dose.
• BPH: Initial dose, 1 mg PO hs. Increase to 2, 5, or 10 mg PO daily. 10 mg/day for
4–6 wk may be required to assess benefit.
PEDIATRIC PATIENTS
Safety and efficacy not established.

Pharmacokinetics
Route Onset Peak
Oral Varies 1 hr

Metabolism: Hepatic; T1/2: 12 hr

Distribution: Crosses placenta; may enter breast milk
Excretion: Feces and urine

Adverse effects
• CNS: Dizziness, headache, drowsiness, lack of energy, weakness, somnolence,
nervousness, vertigo, depression, paresthesia
• CV: Palpitations, sodium and water retention, increased plasma volume, edema,
syncope, tachycardia, orthostatic hypotension, angina
• Dermatologic: Rash, pruritus, alopecia
• EENT: Blurred vision, reddened sclera, epistaxis, tinnitus, dry mouth, nasal
congestion
• GI: Nausea, vomiting, diarrhea, constipation, abdominal discomfort or pain
• GU: Urinary frequency, incontinence, impotence, priapism
• Respiratory: Dyspnea, nasal congestion, sinusitis
• Other: Diaphoresis

Nursing considerations
Assessment
• History: Hypersensitivity to terazosin; CHF; renal failure; pregnancy, lactation
• Physical: Weight; skin color, lesions; orientation, affect, reflexes; ophthalmologic
exam; P, BP, orthostatic BP, supine BP, perfusion, edema, auscultation; R,
adventitious sounds, status of nasal mucous membranes; bowel sounds, normal
output; voiding pattern, urinary output; kidney function tests, urinalysis

Interventions
• Administer or have patient take first dose just before bedtime to lessen likelihood
of first dose effect, syncope, believed due to excessive orthostatic hypotension.
• Have patient lie down, and treat supportively if syncope occurs; condition is self-
limiting.
• Monitor patient for orthostatic hypotension, which is most marked in the morning,
and is accentuated by hot weather, alcohol, exercise.
• Monitor edema, weight in patients with incipient cardiac decompensation, and
add a thiazide diuretic to the drug regimen if sodium and fluid retention, signs of
impending CHF, occur.

Teaching points
• Take this drug exactly as prescribed. Take the first dose just before bedtime. Do
not drive or operate machinery for 4 hr after the first dose.
• These side effects may occur: Dizziness, weakness (more likely to occur when
you change position, in the early morning, after exercise, in hot weather, and
when you have consumed alcohol; some tolerance may occur after taking the drug
for a while, but you should avoid driving or engaging in tasks that require
alertness; change position slowly; use caution when climbing stairs; lie down for a
while if dizziness persists); GI upset (eat frequent small meals); impotence; dry
mouth (suck on sugarless lozenges or ice chips); stuffy nose. Most effects will
gradually disappear.
 • Report frequent dizziness or faintness.

Adverse effects in Italic are most common; those in Bold are life-threatening.