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| __NOTOC__
| | #REDIRECT [[Terazosin#Warnings]] |
| {{Terazosin}}
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| {{CMG}}; {{AE}} {{AK}}
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| ==Warnings==
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| ===Syncope and “First-dose” Effect===
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| '''Terazosin capsules, like other alpha-adrenergic blocking agents, can cause marked lowering of blood pressure, especially [[postural hypotension]], and [[syncope]] in association with the first dose or first few days of therapy. A similar effect can be anticipated if therapy is interrupted for several days and then restarted. Syncope has also been reported with other alpha-adrenergic blocking agents in association with rapid dosage increases or the introduction of another antihypertensive drug. [[Syncope]] is believed to be due to an excessive postural hypotensive effect, although occasionally the syncopal episode has been preceded by a bout of severe [[supraventricular tachycardia]] with heart rates of 120 to 160 beats per minute. Additionally, the possibility of the contribution of hemodilution to the symptoms of [[postural hypotension]] should be considered.
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| To decrease the likelihood of [[syncope]] or excessive hypotension, treatment should always be initiated with a 1 mg dose of terazosin capsules, given at bedtime. The 2 mg, 5 mg and 10 mg capsules are not indicated as initial therapy. Dosage should then be increased slowly, according to recommendations in the Dosage and Administration section and additional antihypertensive agents should be added with caution. The patient should be cautioned to avoid situations, such as driving or hazardous tasks, where injury could result should syncope occur during initiation of therapy.'''
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| In early investigational studies, where increasing single doses up to 7.5 mg were given at 3 day intervals, tolerance to the first dose phenomenon did not necessarily develop and the “first-dose” effect could be observed at all doses. Syncopal episodes occurred in 3 of the 14 subjects given terazosin capsules at doses of 2.5, 5 and 7.5 mg, which are higher than the recommended initial dose; in addition, severe [[orthostatic hypotension]] (blood pressure falling to 50/0 mmHg) was seen in two others and [[dizziness]], [[tachycardia]], and [[lightheadedness]] occurred in most subjects. These adverse effects all occurred within 90 minutes of dosing.
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| In three placebo-controlled BPH studies 1, 2, and 3 (see [[Terazosin clinical pharmacology|CLINICAL PHARMACOLOGY]]), the incidence of [[postural hypotension]] in the terazosin treated patients was 5.1%, 5.2%, and 3.7% respectively.
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| In multiple dose clinical trials involving nearly 2000 hypertensive patients treated with terazosin capsules, syncope was reported in about 1% of patients. Syncope was not necessarily associated only with the first dose.
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| '''If syncope occurs, the patient should be placed in a recumbent position and treated supportively as necessary. There is evidence that the orthostatic effect of terazosin capsules is greater, even in chronic use, shortly after dosing. The risk of the events is greatest during the initial seven days of treatment, but continues at all time intervals'''.
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| ===Priapism===
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| Rarely, (probably less than once in every several thousand patients), terazosin and other α1-antagonists have been associated with [[priapism]] (painful penile erection, sustained for hours and unrelieved by sexual intercourse or masturbation). Two or three dozen cases have been reported. Because this condition can lead to permanent impotence if not promptly treated, patients must be advised about the seriousness of the condition (see [[Terazosin precautions|PRECAUTIONS: Information for Patients]]).<ref name="dailymed.nlm.nih.gov">{{Cite web | last = | first = | title = TERAZOSIN HYDROCHLORIDE CAPSULE [CARDINAL HEALTH] | url = http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=30503dfd-03bd-46d8-8170-d9ed096fd71d | publisher = | date = | accessdate = 7 March 2014 }}</ref>
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| ==References==
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| {{Reflist|2}}
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| [[Category:Cardiovascular Drugs]]
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| [[Category:Drugs]]
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