2.5.4 Alpha-adrenoceptor blocking drugs

ChoiceDrugDosage
1st choiceDoxazosin tablets 1mg, 2mg, 4mg
(immediate release tablets)
Dose: Hypertension, 1mg daily increased after 1-2 weeks to 2mg once daily and thereafter to 4mg once daily, if necessary; max 16mg daily

Prescribing Notes

  • Refer to NICE NG136 Hypertension in adults: diagnosis and management – August 2019.
  • Doxazosin is a fourth-line agent in the treatment of hypertension. It should be used with caution in patients with heart failure, impaired left ventricular function or coronary artery disease.
  • Doxazosin may cause postural hypotension and first dose hypotension. Treatment should be initiated at the lowest possible dose.
  • Standard release doxazosin has a long half-life and can be taken as a single daily dose. Doxazosin m/r formulation is more expensive than the generic standard release formulation with no clinical advantage and is therefore not recommended.