- 49 Downloads
Doxazosin is a long-acting α1-adrenoceptor antagonist structurally related to prazosin and terazosin. Its antihypertensive effect is produced by a reduction in the smooth muscle tone of peripheral vascular beds resulting in a decrease in total peripheral resistance without significant effect on cardiac output or heart rate. In benign prostatic hyperplasia, doxazosin’s effect of relieving bladder outflow obstruction is produced through a reduction in prostatic tone mediated via α1-adrenoceptor blockade.
In most comparative trials doxazosin has proven to be equally effective as the comparator drug in the treatment of mild to moderate hypertension. It has been used in a variety of patient populations including the elderly, Blacks, smokers, and patients with concomitant disease states such as renal dysfunction, hypercholesterolaemia, non-insulin-dependent diabetes mellitus (NIDDM) and respiratory disease. Doxazosin has also been used successfully in combination with β-adrenoceptor antagonists, diuretics, calcium channel antagonists, and angiotensin-converting enzyme inhibitors in patients with hypertension that is uncontrolled with monotherapy.
Doxazosin has a beneficial effect on some of the risk factors associated with coronary heart disease including elevated serum lipid levels, impaired glucose metabolism, insulin resistance and left ventricular hypertrophy. Modest decreases in total cholesterol, low density lipoprotein cholesterol and triglycerides are seen with doxazosin therapy while small increases in high density lipoprotein cholesterol and the high density lipoprotein cholesterol/total cholesterol ratio are consistently reported. Some studies have reported an improvement in glucose tolerance although this effect has been more consistently seen in nondiabetic patients than in patients with NIDDM. Additionally, doxazosin produces a similar reduction in left ventricular hypertrophy to other antihypertensive agents. Modelling-based calculations suggest that doxazosin significantly reduces the risk of developing coronary heart disease in patients with mild to moderate hypertension, although this remains to be confirmed in long term prospective studies.
Doxazosin appears to be a promising agent in the treatment of urinary symptoms associated with benign prostatic hyperplasia. Similar to other α1-adrenoceptor antagonists, doxazosin treatment produces increases in peak and mean urinary flow rates and improves other objective and symptomatic measures.
In acute and long term studies, doxazosin has an incidence of adverse effects and withdrawal rates similar to other α1-adrenoceptor antagonists and other classes of antihypertensive agents. The most commonly reported adverse effects are dizziness, headache, fatigue/malaise and somnolence. Of most concern is the possibility of first-dose postural effects such as syncope; however, the risk of this appears to be minimal with careful dosage titration.
Recent clinical trials have consolidated the place of doxazosin as an effective antihypertensive agent and have expanded its therapeutic potential to include treatment of benign prostatic hyperplasia. While data regarding its effect on cardiovascular mortality are still awaited, doxazosin is now well established as a first-line antihypertensive agent with metabolic properties that may be especially beneficial in patients with concomitant hypercholesterolaemia or NIDDM.
Doxazosin is a quinazoline derivative structurally related to prazosin and terazosin, which acts through selective inhibition of α1-adrenoceptors. Blockade of these receptors in the peripheral vasculature results in vasodilation. A decrease in total peripheral resistance with a corresponding decrease in mean arterial pressure is seen both at rest and following exercise in patients with mild to moderate hypertension after short or long term use of doxazosin. No significant concomitant changes in heart rate or cardiac index are seen. α1-Adrenoceptors are also located at other sites including the prostate and bladder neck, where receptor blockade causes a decrease in resistance to urinary flow.
Results from large scale randomised, double-blind comparative trials have found that doxazosin treatment produces modest reductions in serum total cholesterol, low density lipoprotein cholesterol and triglycerides combined with small increases in high density lipoprotein cholesterol and the high density lipoprotein cholesterol/total cholesterol ratio. These effects have been reported in a variety of hypertensive patient populations including those with non-insulindependent diabetes mellitus (NIDDM) or hypercholesterolaemia, and in smokers.
Doxazosin has either a neutral or positive effect on glucose homeostasis. Numerous studies in nondiabetic patients treated with doxazosin report improvements in glucose metabolism including improvements in the insulin sensitivity index, decreases in fasting and stimulated blood glucose and insulin levels and decreases in glycosylated haemoglobin levels. In patients with NIDDM the effects on glucose metabolism have been less consistent, with some studies reporting improvements and others reporting a neutral effect.
Chronic hypertension is associated with the development of left ventricular hypertrophy resulting in functional impairments which may increase the risk of cardiovascular events. Doxazosin treatment reduces left ventricular mass by approximately 7 to 14% in patients with mild to moderate hypertension, which is similar to that seen with other antihypertensive agents.
While acute intrarenal infusion of doxazosin produces an increase in renal blood flow, long term use of doxazosin appears to have no deleterious effect on renal function.
The oral bioavailability of doxazosin is 62 to 69%. Peak plasma doxazosin concentrations, which are proportional to the dose, occur 1.7 to 3.6 hours after oral administration. Administration of doxazosin with food reduces the rate, but not the extent, of its absorption.
After either oral or intravenous administration the primary route of elimination is by metabolism via O-demethylation or hydroxylation with subsequent excretion in the faeces. Small amounts of the parent drug are eliminated unchanged in the urine and faeces. The terminal elimination half-life ranges from 16 to 22 hours and does not appear to be affected by age, renal function or dose.
In the treatment of mild to moderate hypertension, recent comparative trials have confirmed the relative efficacy of doxazosin compared with other antihypertensive agents and have increased the range of populations in which it has been used. In large scale, randomised trials, treatment with doxazosin 1 to 16 mg/day for up to 4 years produced similar reductions in standing and supine blood pressure to those seen with angiotensin converting enzyme inhibitors, β-adrenoceptor antagonists, calcium channel antagonists, diuretics and other α1-adrenoceptor antagonists. In the Treatment of Mild Hypertension Study (TOMHS), long term treatment with doxazosin reduced diastolic blood pressure to a similar extent to that of acebutolol, amlodipine, chlorthalidone and enalapril, and produced results that were significantly superior to lifestyle modification alone.
In small scale, short term trials in patients with hypertension uncontrolled by monotherapy, doxazosin has proved effective in combination with ACE inhibitors, β-blockers, calcium channel antagonists and diuretics. Addition of doxazosin has resulted in further blood pressure reductions and increased response rates compared with monotherapy.
In patients with NIDDM, treatment with doxazosin produced reductions in blood pressure that were similar to those seen in other patient populations. In these patients, doxazosin produced either a neutral effect or a slight improvement in glycaemic control.
Age, race or concomitant disease do not appear to compromise the efficacy of doxazosin in the treatment of hypertension. Doxazosin has proven effective in hypertensive patients with chronic obstructive pulmonary disease, asthma, renal dysfunction or intermittent claudication, and in smokers.
Recent double-blind, placebo-controlled trials in patients with benign prostatic hyperplasia (BPH) indicate that doxazosin alleviates the urinary symptoms associated with the disease. Several studies of up to 29 weeks’ duration found doxazosin to be superior to placebo on several objective measures including peak and mean urinary flow rates and maximum voiding pressures. In some studies doxazosin also produced significant improvements in symptom scores compared with placebo when assessed by either the patient or the investigator. The improvements tended to be more pronounced in obstructive symptoms (weak stream flow, urinary hesitancy, incomplete bladder emptying and terminal dribbling) than in irritative symptoms (urinary frequency and urgency).
The adverse effects associated with doxazosin are related primarily to its pharmacodynamic properties. In placebo-controlled trials in the treatment of hypertension the most common adverse effects were dizziness (19% of patients), headache (14%), fatigue/malaise (12%), somnolence (5%), oedema (4%), rhinitis (3%) and nausea (3%). Most effects were mild with only 7% of patients discontinuing treatment because of intolerance. First-dose postural effects have been reported with doxazosin although the incidence is low if doses are titrated slowly. Postural effects are dose-related and most likely to occur 2 to 6 hours after a dose.
The incidence of adverse effects with doxazosin has been similar to that with other antihypertensive agents in comparative trials. In TOMHS there was no difference between doxazosin, acebutolol, amlodipine, chlorthalidone and enalapril in an overall adverse effect severity score.
In the treatment of BPH, adverse effects that were reported significantly more frequently with doxazosin than with placebo included hypotension (17%), dizziness (16%), fatigue (8%), oedema (3%) and dyspnoea (3%).
Dosage and Administration
For the treatment of hypertension, the recommended dosage range of doxazosin is 1 to 16 mg/day, initiated at dosages of 1 mg/day to minimise the risk of postural hypotension. Dosage may be titrated upwards at 1- to 2-week intervals until blood pressure goals are reached. In the treatment of BPH dosages of 2 to 12 mg/day have been used; however, most patients respond to 4 mg/day. As in hypertension, treatment should be initiated at a dosage of 1 mg/day and titrated upwards at 1- to 2-week intervals.
KeywordsAdis International Limited Enalapril Atenolol Benign Prostatic Hyperplasia Amlodipine
Unable to display preview. Download preview PDF.
- 2.Davey MJ. Pharmacologic basis for the use of doxazosin in the treatment of essential hypertension. Am J Med 1989 Aug 16; 87: 36S–44S.Google Scholar
- 3.Donnelly R, Elliott HL, Meredith PA, et al. Concentrationeffect relationships and individual responses to doxazosin in essential hypertension. Br J Clin Pharmacol 1989 Nov; 28: 517–26.Google Scholar
- 4.Reid JL, Donnelly R, Meredith PA, et al. Pressor responsiveness in essential hypertension and the effects of treatment with an alpha blocker, calcium antagonist or ace inhibitor. Clin Exp Hypertens A 1989; All Suppl.: 247–56.Google Scholar
- 5.Taylor SH. Clinical pharmacotherapeutics of doxazosin. Am J Med 1989 Aug 16; 87: 2S–11S.Google Scholar
- 7.Jiménez CJF. The role of alpha-adrenergic blockers in the treatment of prostatic hypertrophy. Drugs Today 1993 Jul-Aug; 29: 343–9.Google Scholar
- 8.Jøler M, Riehmann M, Bruskewitz RC. Benign prostatic hyperplasia. Current pharmacological treatment. Drugs 1994; 47 (1): 66–81.Google Scholar
- 9.Andersson KE, Caine M, El-Hilali M, et al. Rationale for α-blockade in BPH therapy. In: Cockett ATK, Khoury S, Aso Y, et al., editors. Proceedings of the 2nd International Consultation on Benign Prostatic Hyperplasia; 1993 June 27–30; Paris. Jersey, Channel Islands: Scientific Communication International Ltd., 1993: 379–87.Google Scholar
- 11.Grimm RH Jr. Treating hypertension and cardiovascular risk: are there trade-offs? Am Heart J 1990 Mar; 119 (3 Pt 2): 729–32 (discussion 732).Google Scholar
- 12.Carruthers G, Dessain P, Fodor G, et al. Comparative trial of doxazosin and atenolol on cardiovascular risk reduction in systemic hypertension. Am J Cardiol 1993 Mar 1; 71: 575–81.Google Scholar
- 13.Fukiyama K, Omae T, Iimura O, et al. A double-blind comparative study of doxazosin and prazosin in the treatment of essential hypertension. Am Heart J 1991 Jan; 121 Suppl.: 317–22.Google Scholar
- 16.Talseth T, Westlie L, Daae L. Doxazosin and atenolol as monotherapy in mild and moderate hypertension: a randomized, parallel study with a three-year follow-up. Am Heart J 1991 Jan; 121 Suppl.: 280–5.Google Scholar
- 18.Ferrara LA, Di ML, Russo O. Doxazosin and captopril in mildly hypercholesterolemic hypertensive patients. The Doxazosin-Captopril in Hypercholesterolemic Hypertensives Study. Hypertension 1993 Jan; 21: 97–104.Google Scholar
- 19.Jones DW, Sands CD. Effects of doxazosin and hydrochlorothiazide on lipid levels in Korean patients with essential hypertension. J Cardiovasc Pharmacol 1993 Sep; 22: 431–7.Google Scholar
- 20.Langdon CG. Doxazosin: a study in a cohort of patients with hypertension in general practice — an interim report. Am Heart J 1991 Jan; 121 Suppl.: 268–73.Google Scholar
- 21.Feher MD, Henderson AD, Wadsworth J, et al. Alpha-blocker therapy; a possible advance in the treatment of diabetic hypertension — results of a cross-over study of doxazosin and atenolol monotherapy in hypertensive non-insulin dependent diabetic subjects. J Hum Hypertens 1990 Oct; 4: 571–7.Google Scholar
- 22.Velussi M, Cernigoi AM, Viezzoli L. Treatment of arterial hypertension in non-insulin-dependent diabetic patients: comparison of doxazosin and enalapril. Curr Ther Res 1993 Mar; 53: 316–28.Google Scholar
- 23.Macphee GJA, Curzio J, Farish E. Placebo-controlled trial of doxazosin in management of patients with hypertension and hypercholesterolaemia. J Cardiovasc Pharmacol 1992 Sep; 20: 429–33.Google Scholar
- 24.Malatino LS, Frisina N, Circo A. A multicenter long-term trial comparing doxazosin and nitrendipine in the treatment of mild to moderate essential hypertension associated with hypercholesterolemia. Curr Ther Res 1993 Sep; 54: 328–38.Google Scholar
- 25.Watanabe K, Hirokawa Y, Hirosawa H, et al. Effects of doxazosin on blood pressure and serum lipids in hypertensive patients [in Japanese]. Igaku Yakugaku 1993; 30 (5): 1269–75.Google Scholar
- 26.Talseth T, Westlie L, Daae LNW Long-term effects of doxazosin and atenolol on serum lipids and blood pressure in hypertensive smokers. J Hypertens 1990 Sep; 8 Suppl. 5: 47–51.Google Scholar
- 33.Neaton JD, Grimm JRH, Prineas RJ, et al. Treatment of Mild Hypertension Study. Final results. JAMA 1993 Aug 11; 270: 713–24.Google Scholar
- 39.Giorda C, Appendino M. Effects of doxazosin, a selective alpha 1-inhibitor, on plasma insulin and blood glucose response to a glucose tolerance test in essential hypertension. Metabolism 1993 Nov; 42: 1440–2.Google Scholar
- 40.Mancini M, Ferrara AL, Strazzullo P, et al. Metabolic disturbances and antihypertensive therapy. J Hypertens 1991 Dec; 9 Suppl. 3: 47–50.Google Scholar
- 42.Andersson P-E, Johansson J, Berne C. Effects of selective alfal and betal-adreno-receptor blockade on lipoprotein and carbohydrate metabolism in hypertensive subjects, with special emphasis on insulin sensitivity. J Hum Hypertens 1994 Mar; 8: 219–26.Google Scholar
- 43.Kageyama S, Yamamoto J, Mimura A, et al. Doxazosin improves insulin sensitivity in hypertensive patients. Clin Ther 1993 Sep-Oct; 15: 829–37.Google Scholar
- 44.Lehtonen A, Kyrklund N, Laine R, et al. Lowered levels of serum insulin, glucose, and cholesterol in hypertensive patients during treatment with doxazosin. Curr Ther Res 1990 Feb; 47: 278–84.Google Scholar
- 45.Maheux P, Facchini F, Jeppesen J, et al. Changes in glucose, insulin, lipid, lipoprotein, and apoprotein concentrations and insulin action in doxazosin-treated patients with hypertension: comparison between nondiabetic individuals and patients with non-insulin-dependent diabetes mellitus. Am J Hypertens 1994 May; 7: 416–24.Google Scholar
- 46.Giorda C, Mason MG, Appendino M, et al. Alpha-1 blocker doxazosin improves insulin sensitivity in diabetic hypertensive patients [abstract]. Diabetes 1993 May; 42 Suppl. 1: 58A.Google Scholar
- 47.Huupponen R, Lehtonen A, Vähätalo M. Effect of doxazosin on insulin sensitivity in hypertensive non-insulin dependent diabetic patients. Eur J Clin Pharmacol 1992 Oct; 43: 365–8.Google Scholar
- 48.Dominguez L, Cefalu W, Weinberger M, et al. Improvement of insulin sensitivity with doxazosin in type II hypertensive diabetics: a multicenter study [abstract]. Am J Hypertens 1994 Apr;7 (Pt 2): 111A.Google Scholar
- 49.Mutou E. Usefulness of doxazosin in the treatment of hypertensive patients with diabetes mellitus [in Japanese]. Shinyaku to Rinsho 1994 May; 43: 930–4.Google Scholar
- 52.Donnelly R, Elliott HL, Howie CA, et al. Vascular pressor responses in treated and untreated essential hypertension. J Cardiovasc Pharmacol 1990 Aug; 16: 191–6.Google Scholar
- 53.Lijnen P, Fagard R, Staessen J, et al. Antihypertensive effect of doxazosin and atenolol in short-term and long-term doubleblind comparison. Methods Find Exp Clin Pharmacol 1990 Oct; 12: 563–73.Google Scholar
- 56.de-Planque BA. A double-blind comparative study of doxazosin and prazosin when administered with beta-blockers or diuretics. Am Heart J 1991 Jan; 121 (1 Pt 2): 304–11.Google Scholar
- 57.Pickering TG, Levenstein M, Walmsley P, et al. Nighttime dosing of doxazosin has peak effect on morning ambulatory blood presssure. Results of the HALT study. Am J Hypertens 1994 Sept; 7 (9 Pt 1): 844–7.Google Scholar
- 60.Lecerof H, Bornmyr S, Lilja B, et al. Acute effects of doxazosin and atenolol on smoking-induced peripheral vasoconstriction in hypertensive habitual smokers. J Hypertens 1990 Sep; 8 Suppl. 5: S29–33.Google Scholar
- 61.Groppelli A, Omboni S, Parati G, et al. Blood pressure and heart rate response to repeated smoking before and after betablockade and selective alpha 1 inhibition. J Hypertens 1990 Sep; 8 Suppl. 5: 35–40.Google Scholar
- 62.Veglio F, Pinna G, Rabbia F, et al. Influence of doxazosin on vasoactive hormones in essential hypertensives [abstract]. Am J Hypertens 1992 May; 5 (Pt 2): 70A.Google Scholar
- 63.Wambach G, Reis U, Stimpel M. Hormonal response to dynamic exercise in hypertension: effect of alpha 1-receptor blocking agent by doxazosin [abstract]. Am J Hypertens 1992 May; 5 (Pt 2): 105A.Google Scholar
- 64.Studer JA, Piepho RW. Antihypertensive therapy in the geriatric patient: II. Areview of the alpha 1-adrenergic blocking agents. J Clin Pharmacol 1993 Jan; 33: 2–13.Google Scholar
- 65.Erley CM, Haefele U, Heyne N, et al. Microalbuminuria in essential hypertension. Reduction by different antihypertensive drugs. Hypertension 1993 Jun; 21 (6 Pt 1): 810–5.Google Scholar
- 66.Oliveros-Palacios MC, Godoy-Godoy N, Colina-Chourio JA. Effects of doxazosin on blood pressure, renin-angiotensin-aldosterone and urinary kallikrein. Am J Cardiol 1991 Jan 15; 67: 157–61.Google Scholar
- 68.Agabiti-Rosei E, Muiesan ML, Rizzoni D, et al. Reduction of left ventricular hypertrophy after longterm antihypertensive treatment with doxazosin. J Hum Hypertens 1992 Feb; 6: 9–15.Google Scholar
- 69.Calvo C, Del RA, Löpez E, et al. Efficacy of doxazosin in hypertensive patients with high risk [abstract]. J Hypertens 1994 Mar; 12 Suppl. 3: 137.Google Scholar
- 72.Sau F, Seguro C, Puddu MB, et al. Hypertensive cardiac hypertrophy, systolic and diastolic function. Effects of doxazosin [abstract]. Am J Hypertens 1993 May; 6 (Pt 2): 106A.Google Scholar
- 76.Westheim A, Daae LNW, Kierulf P, et al. Selective alphal inhibition with doxazosin in hypertensive smokers and nonsmokers: haemodynamic and metabolic effects. J Hypertens 1990 Sep; 8 Suppl. 5: 41–6.Google Scholar
- 77.Hernandez HR, Rafael CA, Guerrero PJ, et al. The effect of doxazosin on platelet aggregation in normotensive subjects and patients with hypertension: an in vitro study. Am Heart J 1991 Jan; 121 Suppl.: 389–94.Google Scholar
- 78.Hernandez HR, Guerrero P Jr, Rafael CA, et al. Evidence of an antiplatelet aggregation action of doxazosin in patients with hypertension: an ex vivo study. Am Heart J 1991 Jan; 121 Suppl.: 395–401.Google Scholar
- 81.Krusell LR, Christensen CK, Pedersen OL. Alpha-adrenoceptor blockade in patients with mild to moderate hypertension: long-term renal effects of doxazosin. J Cardiovasc Pharmacol 1992 Sep; 20: 440–4.Google Scholar
- 83.Conway EL, McNeil JJ, Hurley J, et al. The effects of food on the oral bioavailability of doxazosin in hypertensive subjects. Drug Invest 1993 Aug; 6: 90–5.Google Scholar
- 84.Conway EL, McNeil JJ, Meng L, et al. Single-dose and steadystate pharmacokinetics of doxazosin given in combination with chlorothiazide to hypertensive subjects. Clin Pharmacokinet 1989 Jun; 16: 387–91.Google Scholar
- 86.Oliver RM, Upward JW, Dewhurst AG, et al. The pharmacokinetics of doxazosin in patients with hypertension and renal impairment. Br J Clin Pharmacol 1990 Apr; 29: 417–22.Google Scholar
- 94.Meredith PA, Elliott HL, Kelman AW, et al. Doxazosin: concentration-effect relationships. Br J Clin Pharmacol 1985; 19 (4): 541P.Google Scholar
- 99.Garrett BN, Whyte-Hilliard BL, Sullivan PM, et al. Doxazosin and verapamil in essential hypertension: cross-over evaluation with 24-hour ambulatory blood pressure monitoring and echocardiography [abstract]. Am J Hypertens 1994 Apr; 7 (Pt 2): 39A.Google Scholar
- 101.Grimm RH, Schoenberger J, Liebson P, et al. Alpha blockade and diuretic treatment of hypertension: a double-blind randomized comparison of doxazosin and hydrochlorothiazide [abstract]. Am J Hypertens 1992 May; 5 (Pt 2): 100A.Google Scholar
- 103.Donnelly R, Elliott HL, Meredith PA. Combination of nifedipine and doxazosin in essential hypertension. J Cardiovasc Pharmacol 1992 Apr; 19: 479–86.Google Scholar
- 105.Brown MJ, Dickerson JEC. Alpha-adrenoceptor blockade and Ca++ blockade: a new combination for the treatment of hypertension [abstract]. Br J Clin Pharmacol 1994 May; 37: 474.Google Scholar
- 109.Bainbridge AD, Meredith PA, Elliott HL. A clinical pharmacological assessment of doxazosin and enalapril in combination. Br J Clin Pharmacol 1993 Dec; 36: 599–602.Google Scholar
- 110.Brown MJ, Dickerson JEC. Synergism between alphal-blockade and angiotensin converting enzyme inhibition in essential hypertension. J Hypertens 1991 Dec; 9 Suppl. 6: 362–3.Google Scholar
- 112.Troffa C, Manunta P, Dessì-Fulgheri P, et al. Efficacy and tolerability of doxazosin alone or in combination with chlorthalidone in essential hypertension. Curr Ther Res 1994 Jan; 55: 22–31.Google Scholar
- 114.Bodansky HJ. Doxazosin: alternative antihypertensive treatment [letter]. Diabetic Med 1992 Jul; 9: 583.Google Scholar
- 116.Galeone F, Giuntoli F, Brunelleschi G, et al. Antihypertensive and metabolic effects of long-acting doxazosin on N.I.D.D.M. patients [abstract]. J Hypertens 1994 Mar; 12 Suppl. 3: 82.Google Scholar
- 117.Maruyama H, Kido K, Ikemoto K, et al. Effects of alphal-adrenergic blockade doxazosin on blood pressure, glucose and lipid metabolism in hypertensive patients with diabetes mellitus [abstract]. Am J Hypertens 1993 May; 6: 102A.Google Scholar
- 118.McLaughlin B, Daly L, Devlin JG. Doxazosin in the management of hypertensive diabetes — a cautionary note (?). Ir J Med Sci 1992 Jan; 161: 9–11.Google Scholar
- 119.Giordano M, Matsuda M. Effects of captopril, nifedipine and doxazosin on insulin sensitivity in non-insulin dependent diabetic hypertensive patients [abstract]. Diabetes 1994; 43 Suppl. 1: 79.Google Scholar
- 120.Pickering TG, Levenstein M, Walmsley P. Differential effects of doxazosin treatment on clinic and ambulatory blood pressure according to age and gender [abstract]. Am J Hypertens 1992 May; 5 (Pt 2): 119A.Google Scholar
- 121.Biernacki W, Flenley DC. Doxazosin, a new alpha-1-antagonist drug, controls hypertension without causing airways obstruction in asthma and COPD. J Hum Hypertens 1989 Dec; 3: 419–25.Google Scholar
- 122.Malerba M, Dotti A, Zulli R. Doxazosin in the treatment of hypertension in patients with chronic obstructive pulmonary disease. Curr Ther Res 1991 Jul; 50: 27–37.Google Scholar
- 130.Chappie CR, Carter P, Christmas TJ, et al. A three month double-blind study of doxazosin as treatment for benign prostatic bladder outlet obstruction. Br J Urol 1994; 74: 50–6.Google Scholar
- 132.Fawzy A, Sullivan J, Cook M, et al. A multicenter sixteen-week double blind placebo-controlled dose-response study using doxazosin tablets for the treatment of benign prostatic hyperplasia in patients with mild to moderate essential hypertension [abstract]. J Urol 1993 Apr; 149 Suppl.: 323A.Google Scholar
- 133.Gillenwater JY, Conn RL, Chrysant SG, et al. Doxazosin for the treatment of benign prostatic hyperplasia in patients with mild to moderate essential hypertension: A double-blind, placebocontrolled, dose-response multicenter study. Data on file, study no. US421, Pfizer Laboratories.Google Scholar
- 134.Gillenwater JY, Mobley DL. A sixteen week, double-blind, placebo-controlled, dose-titration study using doxazosin tablets for the treatment of benign prostatic hyperplasia in normotensive males [abstract]. J Urol 1993 Apr; 149 Suppl.: 324A.Google Scholar
- 135.Fawzy A, Braun K, Lewis P, et al. Doxazosin in the treatment of benign prostatic hyperplasia in normotensive patients: a multicenter study. J Urol. In press.Google Scholar
- 136.Holme JB, Christensen MM, Rasmussen PC, et al. 29-week doxazosin treatment in patients with symptomatic benign prostatic hyerplasia — a double-blind placebo-controlled study. Scand J Urol Nephrol 1994 Mar; 28: 77–82.Google Scholar
- 138.Pfizer Inc. Doxazosin mesylate prescribing information. New York, NY, 1994.Google Scholar
- 139.Grimm Jr R, Grandits G, Schoenberger J, et al. Long-term effects on sexual function of various drugs and nutritional hygienic treatments in men and women in the treatment of mild hypertension study (TOMHS). Data on file, Pfizer Laboratories.Google Scholar
- 140.Babamoto KS, Hirokawa WT. Doxazosin: a new alpha 1-adrenergic antagonist. Clin Pharm 1992 May; 11: 415–27.Google Scholar
- 141.Kirby RS, Barry AC. Doxazosin: antihypertensive effect in hypertensive vs. normotensive BPH patients with BPH [abstract]. Am J Hypertens 1993 May; 6: 94A.Google Scholar
- 142.Members of the Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure. The fifth report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC V). National Institutes of Health, Oct 30, 1992.Google Scholar
- 144.The Guidelines Sub-Committee of the WHO/ISH Mild Hypertension Liaison Committee. 1989 Guidelines for the management of mild hypertension: memorandum from a WHO/ISH meeting. J Hypertens 1989; 7: 689–93.Google Scholar