Compound · doxazosin
T1Pharmaceutical

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.

Half-life
22 hours
Bioavailability
65% (oral)
Route
oral
Evidence tier
T1 — Multiple RCTs
Optimization pillars
recovery
References
3 peer-reviewed
Dose ranges

Three tiers ordered by aggressiveness. Tier chips on every OPTIMIZE intervention let you filter the catalog by your evidence tolerance.

conservative
1–2 mg/day
BPH symptom relief
moderate
2–4 mg/day
BPH and mild hypertension
aggressive
4–8 mg/day
Resistant hypertension adjunct
Monitoring
  • psa
  • creatinine
  • egfr
  • lipid-panel
Contraindications
  • orthostatic-hypotension
  • hepatic-impairment
  • concurrent-pde5-inhibitor-at-high-dose
References
  • PMID:8618582Doxazosin for the treatment of benign prostatic hyperplasiaExpert Opin Pharmacother, 1996
  • PMID:14656957The effect of combination therapy with dutasteride and tamsulosin on clinical outcomes in men with symptomatic benign prostatic hyperplasia: CombAT studyEur Urol, 2010
  • PMID:10766434Doxazosin as a treatment for hypertension: the ALLHAT trialJAMA, 2000
Notes

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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