Alpha blocker

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Overview

Alpha blockers (also called alpha-adrenergic blocking agents) constitute a variety of drugs which block α₁-adrenergic receptors in arteries and smooth muscles.

Indications

These drugs may be used to treat:

• benign prostatic hyperplasia (BPH)
• high blood pressure (hypertension). This is not typically the drug of choice unless the patient also has BPH.
• symptoms of non inflammatory chronic pelvic pain syndrome, a type of prostatitis. As a side effect they may reduce blood pressure and result in lightheadedness.

Examples of alpha blockers

Alpha blockers include:

• Doxazosin (Cardura)
• Prazosin (Minipress)
• Phenoxybenzamine
• Phentolamine (Regitine)
• Tamsulosin (Flomaxtra/Flomax)
• Alfuzosin (Uroxatral)
• Terazosin (Hytrin)

Tamsulosin is relatively selective for α_1a-adrenergic receptors, which are mainly present in the prostate. Hence, it may have a more selective action in BPH with minimal effects on blood pressure.

Adverse effects and interactions

By reducing α₁-adrenergic activity of the blood vessels, these drugs may cause hypotension (low blood pressure) and interrupt the baroreflex response. In doing so, they may cause dizziness, lightheadedness, or fainting when rising from a lying or sitting posture (known as orthostatic hypotension or postural hypotension). For this reason, it is generally recommended that alpha blockers should be taken at bedtime. Additionally, the risk of orthostatic hypotension may be reduced by starting at a low dose and titrating upwards as needed.

Because these medications may cause orthostatic hypotension, as well as hypotension in general, these agents may interact with other medications that increase risk for hypotension, such as other antihypertensives and vasodilators.

As discussed above, tamsulosin may have less risk for hypotension and orthostatic hypotension due to its selectivity for α_1a-adrenergic receptors. On the other hand, the drug:

(a) elevates risk for floppy iris syndrome,

(b) might show ADRs characteristic of the sulfa related drugs.

References

• DrugDigest - Alpha blockers
• RxList.com - Tamsulosin
• MeSH alpha-Adrenergic+Blockers

v • d • e Antihypertensives (C02) and diuretics (C03)
Sympatholytic agents	Centrally acting/antiadrenergics α2 agonist (Clonidine, Guanfacine, Methyldopa) imidazoline receptor agonist (Moxonidine, Rilmenidine) adrenergic uptake inhibitor (Rescinnamine, Reserpine) Ganglion-blocking/nicotinic antagonist Mecamylamine, Trimethaphan Peripherally acting/antiadrenergics Alpha blockers: Prazosin • Indoramin • Trimazosin • Doxazosin • Urapidil Guanidine derivatives: Betanidine • Guanethidine • Guanoxan • Debrisoquine • Guanoclor • Guanazodine • Guanoxabenz
Vasodilators	Diazoxide • hydrazinophthalazine (Hydralazine, Dihydralazine, Endralazine, Cadralazine) • Minoxidil • Nitroprusside • Phentolamine
Other antihypertensives	serotonin antagonist (Ketanserin) • endothelin receptor antagonist (Bosentan, Ambrisentan, Sitaxsentan) • MAOI (Pargyline) • THI (Metirosine)
Diuretics	Low ceiling Thiazides Bendroflumethiazide • Hydroflumethiazide • Hydrochlorothiazide • Chlorothiazide • Polythiazide • Trichlormethiazide • Cyclopenthiazide • Methyclothiazide • Cyclothiazide • Mebutizide Sulfonamides Quinethazone • Clopamide • Chlortalidone • Mefruside • Clofenamide • Metolazone • Meticrane • Xipamide • Indapamide • Clorexolone • Fenquizone Other Mersalyl • Theobromine • Cicletanine High ceiling Loop diuretic (Bumetanide, Furosemide, Torsemide) Potassium-sparing ESC blockers (Amiloride, Triamterene) • aldosterone antagonists (Spironolactone, Eplerenone, Potassium canrenoate, Canrenone)

v • d • e Urologicals (G04)
Acidifiers	Ammonium chloride, Calcium chloride
Urinary antispasmodics (primarily antimuscarinics)	Darifenacin, Emepronium, Fesoterodine, Flavoxate, Meladrazine, Oxybutynin, Propiverine, Solifenacin, Terodiline, Tolterodine, Trospium
For erectile dysfunction	prostaglandins: Alprostadil PDE5 inhibitors: Avanafil - Sildenafil - Tadalafil - Udenafil - Vardenafil alpha blockers: Moxisylyte - Phentolamine - Yohimbine others: Apomorphine - Papaverine
Other urologicals	Acetohydroxamic acid, Collagen, Dimethyl sulfoxide, Magnesium hydroxide, Pentosan polysulfate, Phenazopyridine, Phenyl salicylate, Succinimide
For benign prostatic hypertrophy	5α-reductase inhibitors: Dutasteride, Finasteride Alpha blockers: Alfuzosin, Doxazosin, Silodosin, Tamsulosin, Terazosin Herbals: Pygeum africanum, Serenoa repens

v • d • e Receptor agonists, antagonists, and reuptake inhibitors
BA/M: 5-HT (serotonin) receptor	Serotonin receptor agonist • Serotonin antagonist (5-HT3) • Serotonin uptake inhibitor (SSRI)
BA/M: Dopamine receptor	Dopamine agonist • Dopamine antagonist • Dopamine reuptake inhibitor
BA/M: Adrenergic receptor	Adrenergic agonist (Alpha, Beta2) • Adrenergic antagonist (Alpha, Beta) • Adrenergic uptake inhibitor
BA/M: Histamine receptor	Histamine agonist • Histamine antagonist (H1, H2)
Acetylcholine receptor	Cholinergic (Muscarinic, Nicotinic) • Anticholinergic (Muscarinic, Nicotinic) • Acetylcholinesterase inhibitor
AA: GABA receptor	GABA agonist • GABA antagonist
AA: Glutamate receptor	NMDA receptor (NMDA receptor antagonist)

v • d • e WikiDoc Research Resources for Alpha blocker (Click show to right to view)
Articles on Alpha blocker	Most recent articles on Alpha blocker • Most cited articles on Alpha blocker • Review articles on Alpha blocker • Articles on Alpha blocker in N Eng J Med, Lancet, BMJ
Media (Slides, Video, Images, MP3) on Alpha blocker	Powerpoint slides on Alpha blocker • Images of Alpha blocker • Photos of Alpha blocker • Podcasts & MP3s on Alpha blocker • Videos on Alpha blocker
Evidence Based Medicine Regarding Alpha blocker	Cochrane Collaboration on Alpha blocker • Bandolier on Alpha blocker • TRIP on Alpha blocker
Cost Effectiveness of Alpha blocker	Cost Effectiveness of Alpha blocker
Clinical Trials Involving Alpha blocker	Ongoing Trials on Alpha blocker at Clinical Trials.gov • Trial results on Alpha blocker • Clinical Trials on Alpha blocker at Google
Guidelines / Policies / Government Resources (FDA/CDC) Regarding Alpha blocker	US National Guidelines Clearinghouse on Alpha blocker • NICE Guidance on Alpha blocker • NHS PRODIGY Guidance • FDA on Alpha blocker • CDC on Alpha blocker
Textbook Information on Alpha blocker	Books and Textbook Information on Alpha blocker
Pharmacology Resources on Alpha blocker	Dosing of Alpha blocker • Drug interactions with Alpha blocker • Side effects of Alpha blocker • Allergic reactions to Alpha blocker • Overdose information on Alpha blocker • Carcinogenicity information on Alpha blocker • Alpha blocker in pregnancy • Pharmacokinetics of Alpha blocker •
Genetics, Pharmacogenomics, and Proteinomics of Alpha blocker	Genetics of Alpha blocker • Pharmacogenomics of Alpha blocker • Proteomics of Alpha blocker
Newstories on Alpha blocker	Alpha blocker in the news • Be alerted to news on Alpha blocker • News trends on Alpha blocker
Commentary on Alpha blocker	Blogs on Alpha blocker
Patient Resources on Alpha blocker	Patient resources on Alpha blocker • Discussion groups on Alpha blocker • Patient Handouts on Alpha blocker • Directions to Hospitals Treating Alpha blocker • Risk calculators and risk factors for Alpha blocker
Healthcare Provider Resources on Alpha blocker	Symptoms of Alpha blocker • Causes & Risk Factors for Alpha blocker • Diagnostic studies for Alpha blocker • Treatment of Alpha blocker
Continuing Medical Education (CME) Programs on Alpha blocker	CME Programs on Alpha blocker
International Resources on Alpha blocker	Alpha blocker en Espanol • Alpha blocker en Francais
Business Resources on Alpha blocker	Alpha blocker in the Marketplace • Patents on Alpha blocker
Informatics Resources on Alpha blocker	List of terms related to Alpha blocker

de:Alphablocker

fr:Alpha-bloquant it:Alfa bloccante

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Acknowledgement and Attribution Regarding Sources of Content

Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .