Hytrin

Hytrin (terazosin hydrochloride) is a selective alpha-1 adrenergic blocking agent prescribed for the management of hypertension and symptomatic benign prostatic hyperplasia (BPH). As an expert-class medication, it functions by relaxing blood vessels and prostate/bladder neck smooth muscle, leading to improved urinary flow and blood pressure reduction. Its dual-action profile makes it a versatile therapeutic option in cardiovascular and urological practice, with a well-established efficacy and safety profile documented through extensive clinical use.

Features

• Active ingredient: Terazosin hydrochloride
• Available in 1 mg, 2 mg, 5 mg, and 10 mg tablet strengths
• Selective alpha-1 adrenoreceptor antagonist
• Once-daily dosing regimen for convenience
• FDA-approved for hypertension and BPH
• Bioavailability approximately 90% when taken orally
• Peak plasma concentration reached within 1 hour
• Half-life of approximately 12 hours

Benefits

• Effectively lowers both systolic and diastolic blood pressure
• Reduces symptoms of benign prostatic hyperplasia including urinary hesitancy and nocturia
• Improves urinary flow rates and reduces residual urine volume
• Single daily dosing supports medication adherence
• Well-tolerated profile with side effects typically diminishing over time
• Can be used as monotherapy or in combination with other antihypertensive agents

Common use

Hytrin is primarily prescribed for two clinical indications: hypertension management and treatment of symptomatic benign prostatic hyperplasia. In hypertensive patients, it works by dilating peripheral blood vessels, reducing peripheral vascular resistance. For BPH, it relaxes smooth muscle in the prostate and bladder neck, decreasing urinary obstruction. Physicians often initiate therapy for both conditions simultaneously when comorbidities exist, though careful titration is required, particularly in elderly patients who may be more susceptible to orthostatic effects.

Dosage and direction

For hypertension: Initial dose is 1 mg at bedtime. Dose may be increased gradually to 2 mg, 5 mg, or up to 20 mg daily as needed. Maximum recommended dose is 20 mg daily. For BPH: Initial dose is 1 mg at bedtime, gradually increased to 2 mg, 5 mg, or 10 mg once daily. Dose titration should occur at intervals of 2-4 weeks based on symptomatic response and tolerability. Tablets should be swallowed whole with water, with or without food. The first dose should be taken at bedtime to minimize potential syncopal episodes.

Precautions

Patients should be cautioned about the potential for first-dose syncope, particularly with initial dosing or dosage increases. Orthostatic hypotension may occur, especially when rising quickly from sitting or lying positions. Regular blood pressure monitoring is recommended, particularly during dose titration. Use with caution in patients with renal impairment, as dosage adjustment may be necessary. Hepatic impairment requires careful monitoring due to potential altered metabolism. Patients should avoid driving or operating machinery until their response to therapy is established.

Contraindications

Hytrin is contraindicated in patients with known hypersensitivity to terazosin hydrochloride or any component of the formulation. It should not be used in patients experiencing orthostatic hypotension. Concomitant use with other alpha-adrenergic blocking agents is contraindicated due to potential additive effects. Patients with severe hepatic impairment should avoid use unless benefits clearly outweigh risks. Not recommended for pediatric use as safety and efficacy have not been established.

Possible side effect

Common side effects include dizziness (19%), asthenia (11%), nasal congestion (6%), peripheral edema (5%), and somnolence (5%). Less frequent adverse reactions include palpitations, nausea, blurred vision, and weight gain. Syncope occurs in approximately 1% of patients, typically with initial dosing. Priapism, though rare, constitutes a medical emergency requiring immediate attention. Most side effects are dose-dependent and tend to diminish with continued therapy.

Drug interaction

Concomitant use with other antihypertensive agents may produce additive hypotensive effects. PDE5 inhibitors (sildenafil, tadalafil, vardenafil) may enhance the hypotensive effect. NSAIDs may reduce the antihypertensive efficacy. Beta-blockers and calcium channel blockers may potentiate blood pressure lowering effects. Diuretics require careful monitoring when combined therapy is initiated. CYP3A4 inhibitors may increase terazosin concentrations.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is nearly time for the next scheduled dose. In that case, the missed dose should be skipped and the regular dosing schedule resumed. Patients should never double the dose to make up for a missed administration. Consistent daily dosing is important for maintaining therapeutic effects, particularly for blood pressure control.

Overdose

Symptoms of overdose may include severe hypotension, dizziness, lightheadedness, and syncope. Supportive care including supine positioning with legs elevated is indicated. Volume expansion with intravenous fluids may be necessary. Vasopressors may be required for persistent hypotension, though alpha-adrenergic agonists should be avoided. Gastric lavage may be considered if ingestion was recent. Hemodialysis is not effective due to high protein binding.

Storage

Store at controlled room temperature 20-25°C (68-77°F). Protect from light and moisture. Keep container tightly closed. Do not store in bathroom medicine cabinet due to humidity fluctuations. Keep out of reach of children and pets. Do not use after expiration date printed on packaging. Properly dispose of unused medication through take-back programs.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Individual patient responses may vary. Healthcare providers should exercise clinical judgment when prescribing Hytrin. Patients should not alter their dosage without consulting their physician. Full prescribing information should be reviewed before initiation of therapy.

Reviews

Clinical studies demonstrate Hytrin’s efficacy in reducing blood pressure by 10-15 mmHg systolic and 5-10 mmHg diastolic. In BPH patients, peak urinary flow rates improve by 30-40% with corresponding symptom score reductions of 40-50%. Long-term studies show maintained efficacy over 24+ months of treatment. Patient satisfaction surveys indicate improved quality of life measures particularly regarding urinary symptoms. Most adverse effects are reported as mild to moderate and transient in nature.