Doxazosin
Selective alpha-1 adrenergic receptor antagonist. Blocks post-synaptic alpha-1 receptors in vascular smooth muscle and prostatic tissue, reducing peripheral vascular resistance and relieving bladder outlet obstruction. Extended-release formulation provides smoother pharmacokinetic profile with less first-dose hypotension than immediate-release.
Three tiers ordered by aggressiveness. Tier chips on every OPTIMIZE intervention let you filter the catalog by your evidence tolerance.
- psa
- creatinine
- egfr
- lipid-panel
- orthostatic-hypotension
- hepatic-impairment
- concurrent-pde5-inhibitor-at-high-dose
- PMID:8618582Doxazosin for the treatment of benign prostatic hyperplasia — Expert Opin Pharmacother, 1996
- PMID:14656957The effect of combination therapy with dutasteride and tamsulosin on clinical outcomes in men with symptomatic benign prostatic hyperplasia: CombAT study — Eur Urol, 2010
- PMID:10766434Doxazosin as a treatment for hypertension: the ALLHAT trial — JAMA, 2000
Doxazosin occupies a practical niche in the optimization framework. Men on TRT who develop prostate growth often face urinary symptoms that degrade sleep quality and daily function. Alpha-1 blockers provide rapid symptomatic relief while the 5-alpha reductase inhibitor works on volume reduction over months. The 22-hour half-life supports once-daily bedtime dosing, which also leverages the mild hypotensive effect to improve sleep-onset blood pressure dipping. First-dose syncope is real but predictable. Start at 1mg at bedtime. Titrate over weeks. The compound is not glamorous. It solves a specific quality-of-life problem that many men on hormones quietly struggle with.
This is not medical advice
Discuss with a licensed clinician before starting, stopping, or changing any compound. This page documents what the research literature describes — it is not a prescription.
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