Has anyone used any of the alpha blockers for hypertension. Names like Cardura, Minipres and Hytrin (all generically ending in -zosin?)
Would you share your results both good and bad?

Do you think it would be an alternative to a diuretic for a very salt dependent hypertensive like me. I've been taking thiazides for over 2 decades and I'm afraid that the long dosage will rear up and bite me soon. I really seem to have no response (well, none good) to either ACEI or ARB classes although beta-blockers DO work well but I can't live with the side effects!

I was treated for Hypertension with Alpha Blockers, but only becuase it was due to Pheochromocytoma. With that, Alpha Blockers are the only thing that works to get the BP down. I took Prazosin as I was going into Hypertensive Crisis on a daily basis. They needed to get my BP down quickly. I started out taking 3 a day and was up to 16 a day when I was finally blocked and had my BP under control.

I would look into the side effects of Alpha Blockers, especially if you are a male and probably only take them if it's your only alternative to control your Blood Pressure. They made me very tired all of the time and also made my heart race. They had to give me diltiazen to help with that until I was blocked and they could add Beta Blockers.

Lenin,
I only know a little about one of the alphas..clonidine (Catapres). It's very sedating and about 1/3 of patients experience this side effect which is a greater percentage [I believe] than the fatigue factor caused by the betas.

zuzu xx

Thanks, kids.

My doctor mention alpha-blockers and a few minutes later I asked what he knew about clonidine. He said it was a benzodiazepine. I didnt feel likke arguing but I think he was thinking of clonazepam... :rolleyes:. I said, some people are taking are taking it for HBP and he said, yeah, maybe it would lower pressure.

Why he hasn't yet been strangled in his office is a mystery to me.

I could do with something sedating at night if it would replace half or more of my HZTZ (now 50 mg...and ALL that I take for BP since I've decided my losartan was adding NOTHING good to the picture.)

Maybe my cardio will have a better idea about clonidine for me. I have a referral in hand and will see him after I deal with the true horror of life: THE DENTIST! :eek: :eek:

Do some web searches on ALLHAT and alpha blockers and you'll see that the National Institutites of Health stopped using alpha blockers in their huge clinical trials of various bp medicines because the medicine was clearly hurting patients. Can't think of a more definitive recommendation against using them.

I searched alpha blockers and got this from drugdigest.org.
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Alpha Blockers

Alpha blockers are commonly used to treat hypertension (high blood pressure) or benign prostatic hyperplasia (BPH). This class of drugs is generally not preferred as a first line treatment to lower blood pressure, but is most frequently used in combination with other medications when blood pressure is difficult to control.

Alpha blockers may be a good choice of drug therapy in men who have both hypertension and benign prostatic hyperplasia (BPH), a common disorder in older men that involves enlargement of the prostate and can cause urinary problems such as difficulty urinating and increased frequency of urination.

Drugs in this Class
Doxazosin (Cardura)
Prazosin (Minipress)
Terazosin (Hytrin)

Summarizing the Evidence


There have only been a few studies directly comparing these drugs with one another for the treatment of high blood pressure. Based on those studies, all three drugs lowered blood pressure similarly and there does not seem to be a major advantage of one alpha blocker over another in terms of blood pressure lowering. In addition, there was not a significant difference in side effects.

Based on the results of a large study known as the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT), alpha blockers should generally not be used as first line therapy for the treatment of hypertension, unless they are being used for both hypertension and benign prostatic hyperplasia (BPH).

Alpha blockers are generally well tolerated with mild side effects such as drowsiness, dizziness, lightheadedness, heart palpitation, lightheadedness, and fainting. There may be more dizziness associated with alpha blockers especially after the first few doses, as compared to other classes of drugs used to lower blood pressure. These side effects can sometimes be minimized or avoided by taking the alpha blocker at bedtime and starting at low doses and gradually working up to higher doses slowly if needed. No major differences in the frequency of side effects among the alpha blockers are apparent.
Dosing and Administration

Doxazosin and terazosin are typically taken once daily. However, prazosin is typically taken three times per day because it has a shorter duration of action.
Generic Availability

Doxazosin (Cardura), prazosin (Minipress) and terazosin (Hytrin) are all available in generic formulations.
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Trying to find the category for clonidine is frustrating. It is variously relegated to "other hypertensive medication", "centrally acting hypertensive medication", "alpha-2 adrenergic receptor" and "alpha adrenergic agonist". A couple other drugs in this class are guanabenz and methyldopa.

I found this information on clonidine, but I can't remember where:
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Clonidine is a centrally-acting alpha-2 agonist. It selectively stimulates receptors in the brain that monitor catecholamine levels in the blood. These receptors close a feedback loop that begins with descending sympathetic nerves from the brain that control the production of catacholamines (epinephrine , also known as adrenaline, and norepinephrine) in the adrenal medulla. By fooling the brain into believing that catacholamine levels are higher than they really are, clonidine causes the brain to reduce its signals to the adrenal medulla, which in turn lowers catacholamine production and blood levels. The result is a lowered heart rate and blood pressure, with side effects of dry mouth and fatigue.
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