NHS Dudley Health Economy Medicines Formulary
Home > 2 Cardiovascular system > 2.5 Hypertension and heart failure > 2.5.4 Alpha-adrenoceptor blocking drugs

2.5.4 Alpha-adrenoceptor blocking drugs

General guidance

For Dudley Hypertension Pathway click here

• Alpha-blockers are useful drugs for the treatment of both hypertension and benign prostatic hypertrophy.
• In hypertension they are generally considered as forth line agents but can prove useful especially resistant cases and cases due to renal disease.
• Prazosin has post-synaptic alpha-blocking and vasodilator properties and rarely causes tachycardia and is useful in congestive cardiac failure and Raynaud’s syndrome in addition to hypertension and BPH. However, it may cause a rapid reduction in blood pressure following the first dose and should therefore be introduced with caution.

• Other alpha-blockers have similar properties to prazosin but are claimed to be associated with less first dose hypotension, nevertheless these agents should also be introduced cautiously.
• For details of the treatment of BPH please see section 7.4.1

Recommended drugs

Doxazosin £

Prazosin £


Drug Traffic Light Key:

Green – On Formulary

Amber – Restricted use, see local guidelines      

Purple – Specialist use/initiation

Red – Non Formulary


Relative Costs Key (where indicated):

£££££ - high

£££ - moderate

£ - low

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