Alpha-Adrenoceptor Blockers |
Doxazosin | Cardura Cardura XL | 1 mg at bedtime 4 mg ER once daily | 1–16 mg once daily 4–8 mg ER once daily | $0.29/4 mg $6.74/4 mg ER | $8.70 (4 mg once daily) $202.20 (4 mg ER once daily) | Syncope with first dose; postural hypotension, dizziness, palpitations, headache, weakness, drowsiness, sexual dysfunction, anticholinergic effects, urinary incontinence; first-dose effects may be less with doxazosin. | May ↑ HDL and ↓ LDL cholesterol. May provide short-term relief of obstructive prostatic symptoms. Less effective in preventing cardiovascular events than diuretics. |
Prazosin | Minipress | 1 mg at bedtime | 2–20 mg in 2 or 3 doses | $0.95/5 mg | $57.00 (5 mg twice daily) | | |
Terazosin | Hytrin | 1 mg at bedtime | 1–20 mg in 1 or 2 doses | $1.60/1, 2, 5, 10 mg | $48.00 (5 mg once daily) | | |
Central Sympatholytics |
Clonidine | Catapres Catapres TTS (transdermal patch) | 0.1 mg twice daily 0.1 mg/day patch weekly | 0.2–0.6 mg in 2 doses 0.1–0.3 mg/day patch weekly | $0.21/0.1 mg $55.77/0.2 mg patch | $12.60 (0.1 mg twice daily) $223.08 (0.2 mg weekly) | Sedation, dry mouth, sexual dysfunction, headache, bradyarrhythmias; side effects may be less with guanfacine. Contact dermatitis with clonidine patch. Methyldopa also causes hepatitis, hemolytic anemia, fever. | “Rebound” hypertension may occur even after gradual withdrawal. |
Clonidine and chlorthalidone | Clorpres | 0.1 mg/15 mg one to three times daily | 0.1 mg/15 mg–0.3 mg/15 mg | $2.77/0.1 mg/15 mg | $166.20/0.1 mg/15 mg twice daily | | |
Guanfacine | Tenex | 1 mg once daily | 1–3 mg once daily | $0.87/1 mg | $26.10 (1 mg once daily) | | |
Methyldopa | Aldochlor | 250 mg twice daily | 500–2000 mg in 2 doses | $0.66/500 mg | $39.60 (500 mg twice daily) | | Methyldopa should be avoided in favor of safer agents. |
Peripheral Neuronal Antagonists |
Reserpine | (generic) | 0.05 mg once daily | 0.05–0.25 mg once daily | $1.19/0.1 mg | $35.70 (0.1 mg once daily) | Depression (less likely at low dosages, ie, < 0.25 mg), night terrors, nasal stuffiness, drowsiness, peptic disease, GI disturbances, bradycardia. | |
Direct Vasodilators |
Hydralazine | Apresoline | 25 mg twice daily | 50–300 mg in 2–4 doses | $0.15/25 mg | $9.00 (25 mg twice daily) | GI disturbances, tachycardia, headache, nasal congestion, rash, LE-like syndrome. | May worsen or precipitate angina. |
Minoxidil | (generic) | 5 mg once daily | 10–40 mg once daily | $1.28/10 mg | $38.40 (10 mg once daily) | Tachycardia, fluid retention, headache, hirsutism, pericardial effusion, thrombocytopenia. | Should be used in combination with beta-blocker and diuretic. |