Alphapress (Prazosin) 1 is an alpha-blocker used to treat high blood pressure, reduce heart attack or stroke risk, and manage heart failure and prostate enlargement in men.
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Prazosin works by selectively inhibiting postsynaptic alpha-1-adrenoreceptors in vascular smooth muscle, leading to a reduction in total peripheral vascular resistance. In hypertensive individuals, it effectively lowers both systolic and diastolic blood pressure, with a more pronounced effect on diastolic pressure. Notably, abrupt discontinuation of Prazosin does not result in rebound hypertension.
For patients with congestive heart failure (CHF), Prazosin enhances therapeutic outcomes by reducing left ventricular filling pressure and cardiac impedance, while simultaneously improving cardiac output. Unlike some other medications, Prazosin does not induce reflex tachycardia, and in normotensive patients, its effect on blood pressure is minimal.
In individuals with Raynaud’s disease, Prazosin alleviates symptoms by reducing the severity, frequency, and duration of attacks. Additionally, at low doses, it helps improve urinary flow in men with benign prostatic hyperplasia (BPH) by blocking alpha-1 receptors in prostatic and urethral smooth muscle. Clinical research has also indicated that Prazosin therapy does not lead to unfavorable changes in serum lipid profiles.
Since tolerance is better when initiated at a low dose, therapy should start with the lowest effective dose and be adjusted based on the patient’s individual response. Typically, the therapeutic effect is observed within 1 to 14 days at a particular dosage. Once an optimal response is achieved, the dose should be maintained before considering further adjustments.
New Patients (Not on Other Antihypertensive Therapy):
Gradual dose increments may continue until a maximum daily dose of 20 mg is reached, divided into multiple doses.
Patients on Diuretics (With Uncontrolled Blood Pressure):
Patients on Other Antihypertensive Medications (With Uncontrolled Blood Pressure):
Since combining Prazosin with beta-blockers, calcium antagonists, or ACE inhibitors may significantly lower blood pressure, a low starting dose is strongly recommended.
Patients With Moderate to Severe Kidney Impairment:
Daily doses exceeding 4 mg should be used with caution as their safety and efficacy have not been well established.
Adding a diuretic or another antihypertensive medication to Prazosin has been shown to further lower blood pressure due to an additive hypotensive effect.
Prazosin has not shown teratogenic effects in animals, but its safety during pregnancy is not fully established. It has been used in severe hypertension during pregnancy without reported fetal abnormalities. It is excreted in small amounts in breast milk, so caution is advised for nursing mothers.
Store below 30°C, away from light, and moisture, and out of children's reach.
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