Terazosin (Hytrin) is an orally available medicine that acts on the alpha receptors. It is used to treat the obstructive symptoms associated with an enlarged prostate. It is occasionally used for the treatment of hypertension.

Indications of Terazosin:

• Benign prostatic hyperplasia:

  • It is used for the treatment of symptomatic benign prostatic hyperplasia.

• Hypertension:

  • It is indicated for the management of hypertension as an alternate agent.

• Off Label Use in Adults:

  • Ureteral calculi expulsion

Terazosin dose in Adults

Terazosin dose in the treatment of Benign prostatic hyperplasia:

• Initial: 1 mg per oral at bedtime; thereafter, titrate upwards, if needed, over several weeks, balancing therapeutic benefit with terazosin-induced postural hypotension;
• Most patients require 10 mg once daily.
• The maximum dose is 20 mg/day

Terazosin dose in the treatment of Hypertension as an alternative agent:

• Initial: 1 mg per oral once daily at bedtime to prevent hypotension, titrate as needed based on patient response up to a dose of 20 mg daily in 1 or 2 divided doses.

Terazosin dose in the treatment of Ureteral calculi expulsion:

• 2 to 5 mg per oral at bedtime for up to 2 weeks or until stone expulsion;
• It may be used as adjunctive therapy to shock wave lithotripsy.

Terazosin dose in Childrens

Terazosin dose in the treatment of Hypertension:

• Children and Adolescents: Limited data available:

  • Initial: 1 mg per oral once a day, typically administered at bedtime;
  • slowly increase the dose to achieve desired blood pressure as tolerated.
  • The maximum daily dose: 20 mg/day.

Pregnancy Risk Factor C

• Animal studies did not reveal any adverse outcomes.
• It should not be used as a first-line medication for hypertension during pregnancy.

Use during breastfeeding:

• It is not known if breast milk contains hytrin.
• The manufacturer suggests that breastfeeding mothers exercise caution when using the drug.

Dose adjustment in renal disease:

• No dosage adjustment necessary.

Hemodialysis:

• 10% dialyzable; supplemental dose not necessary.

Hytrin Dose adjustment in liver disease:

• There are no dosage adjustments provided in the manufacturer’s labeling.

Common Side Effects of Terazosin (Hytrin):

• Central nervous system:

  • Dizziness
  • Myasthenia Gravis

Uncommon Side Effects of Terazosin (Hytrin):

• Cardiovascular:

  • Peripheral Edema
  • Orthostatic Hypotension
  • Palpitations
  • Tachycardia
  • Syncope

• Central Nervous System:

  • Drowsiness
  • Paresthesia
  • Vertigo

• Endocrine & Metabolic:

  • Decreased Libido
  • Weight Gain

• Gastrointestinal:

  • Nausea

• Genitourinary:

  • Impotence

• Neuromuscular & Skeletal:

  • Limb Pain
  • Back Pain

• Ophthalmic:

  • Blurred Vision

• Respiratory:

  • Nasal Congestion
  • Dyspnea
  • Sinusitis

Contraindication to Terazosin (Hytrin):

Hypersensitivity to any drug or component of the formulation

Warnings and precautions

• CNS depression:

  • Hytrin can cause depression in the central nervous system, which could lead to mental or physical impairments.
  • It is important to warn patients about driving or operating machinery.

• Floppy iris syndrome:

  • People who had been treated with alpha-blockers before cataract surgery showed intra-operative folly iris syndrome.

• Syncope/orthopastatic hypotension:

  • It can cause severe orthostatic hypotension or syncope, particularly if it is administered in the initial few days.

• Priapism

  • Although priapism is rare, Hytrin can cause it. Medical assistance is needed for any erections that last more than four hours.

• Heart failure:

  • It can also aggravate underlying myocardial dysfunction.

Terazosin: Drug Interaction

Monitoring parameters:

• BP in standing,sitting and supine position and at regular intervals throughout therapy
• Urinary symptoms

How to administer Terazosin (Hytrin)?

• It should be given orally at the same time each day.

Mechanism of action of Hytrin:

• Hytrin, an alpha-blocking drug that allows peripheral postsynaptic blocking to result in arterial tone reduction, maintaining the negative feedback loop that is mediated through the peripheral presynaptic beta-receptors.
• It relaxes the smooth muscle in the bladder neck, reducing obstruction at the bladder outlet.

The onset of action:

• Antihypertensive effect: 15 minutes
• Peak effect: Antihypertensive effect: 2 to 3 hours

Duration of action:

• Antihypertensive effect: 24 hours

Absorption:

• Rapid and complete

Protein binding:

• 90% to 94%

Metabolism:

• Occurs in the liver, minimal first-pass

Half-life elimination:

• 12 hours

Time to peak plasma concentration:

• 1 hour; delayed 40 minutes with food

Excretion:

• Feces (60%, 20% as unchanged drug)
• urine (40%, 10% as unchanged drug)

Terazosin Brand Names (International):

• APO-Terazosin
• DOM-Terazosin
• Hytrin
• MYLAN-Terazosin
• PHL-Terazosin
• PMS-Terazosin
• TEVA-Terazosin
• Adecur
• Adenex
• Alfaprost
• Andrin
• Benaprost
• Conmy
• Deflox
• Eglidon
• Flotrin
• Hykor
• Hyron
• Hytracin
• Hytrin
• Hytrin BPH
• Hytrine
• Hytrinex
• Hytroz
• Hyzin
• Itrin
• Kinzosin
• Kozosin
• Lontencin
• Magnurol
• Mayul
• Olyster
• Prostera
• Prostol
• Ralsin
• Rosyn
• Setegis
• Sinalfa
• Sinraz
• Sutif
• Teracin
• Teradrin
• Teragen
• Teralfa
• Terapam
• Terasin
• Terastat
• Terazoflo
• Terazon
• Terazopress
• Terazosab
• Tracin
• Trasin
• Tructum
• Vasomet
• Vicard
• Zytrin

Terazosin Brands in Pakistan: