Prazosin is an alpha-1 adrenergic receptor blocker primarily used to treat hypertension (high blood pressure) and to alleviate symptoms of post-traumatic stress disorder (PTSD). This medication relaxes vascular smooth muscle, reduces peripheral vascular resistance, and thereby lowers blood pressure. Recent studies also indicate its effectiveness in relieving nightmares and flashbacks in PTSD patients.
Its mechanism of action involves blocking alpha-1 receptors, reducing norepinephrine-induced vasoconstriction responses. Unlike other antihypertensive drugs, Prazosin also has a beneficial effect on urinary obstruction caused by benign prostatic hyperplasia, but this use should be evaluated and prescribed by a physician.
The main brand name is Praxin®, and the generic name is Prazosin Hydrochloride. Other brand names may exist in different countries or regions, but the active ingredient remains the same. The medication is available in tablet and dissolvable tablet forms for patient convenience.
Generic and brand-name drugs have the same efficacy and safety profiles, but generic versions are usually less expensive. Patients should verify that the active ingredient on the packaging is Prazosin Hydrochloride and avoid switching manufacturers without medical approval.
This medication belongs to the alpha-1 adrenergic receptor blocker class, classified as an antihypertensive agent. It acts directly on the vascular system and can be used synergistically with other antihypertensive drugs such as diuretics and calcium channel blockers.
Pharmacologically, Prazosin also exhibits peripheral alpha-1 receptor blockade, giving it a unique advantage in treating certain neuropsychiatric symptoms like PTSD, but interactions with other drug classes should be monitored.
The primary indication is primary hypertension (systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg), used alone or in combination with other antihypertensive medications. Second-line indications include symptom relief in PTSD, especially sleep disturbances and re-experiencing symptoms.
In some countries, it is also approved for urinary difficulties caused by benign prostatic hyperplasia, but caution is advised as this may increase the risk of hypotension. Physicians may prescribe this medication off-label based on personalized medical considerations.
Mild side effects include dizziness, headache, fatigue, and lower limb edema. About 15-20% of patients may experience orthostatic hypotension during initial treatment, especially dizziness when standing, so slow movements upon standing are recommended to prevent falls.
Contraindications: Patients allergic to Prazosin, those with severe heart failure, or those who have experienced shock reactions after use should avoid this medication. Use during pregnancy should be limited to necessary cases, and breastfeeding women should suspend nursing.
Black box warning includes the risk of orthostatic hypotension, especially when starting therapy, and it is recommended to take the first dose at bedtime. When combined with other antihypertensives, dose reduction is necessary to prevent excessive blood pressure lowering.
Combining with ACE inhibitors and beta-blockers can enhance blood pressure reduction, increasing the risk of fainting. Use with selective serotonin reuptake inhibitors (SSRIs) may increase the risk of hypotension, requiring dose adjustments.
Initial dose is usually 1 mg once daily, gradually increased every 3-7 days to the target dose (typically 2-5 mg daily). Patients with severe liver impairment should reduce the dose by half; crushing or chewing sustained-release tablets is strictly prohibited.
Take after breakfast to reduce gastrointestinal discomfort, but dissolvable tablets can be taken directly. Avoid eating within 30 minutes after dosing to ensure absorption. Take at a fixed time daily to maintain stable blood drug levels.
If a dose is missed and more than 4 hours remain before the next dose, take the missed dose immediately and adjust subsequent timing accordingly. If close to the next dose, skip the missed dose and resume normal dosing the following day. Do not double doses to make up for missed medication.
If doses are missed for more than 2 days, contact a physician immediately and avoid self-adjusting the dose. If dizziness worsens after missing a dose, rest and measure blood pressure before deciding whether to take the missed dose.
Acute overdose can cause severe hypotension, potentially leading to shock or renal impairment. If overdose is suspected, seek immediate medical attention; do not induce vomiting or take other antidotes without medical supervision.
Emergency treatment includes intravenous fluid infusion, vasopressor use, and renal function monitoring. Store medication in a locked cabinet out of reach of children and unauthorized persons.
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