Drug Status Key

  • Preferred
  • On Formulary
  • Specialist Initiation
  • Shared Care
  • Hospital Only
  • Under Review
  • New on System

2.5.4 Alpha-adrenoceptor blocking drugs


  1. NICE/BHS guidelines suggest doxazosin therapy is additional to other antihypertensive medications.
  2. The 4mg modified release formulation of doxazosin is significantly more expensive but does reduce post dose hypotension compared with the standard formulation.
  3. In some patients it is safer to use the non-XL formulation bd to avoid this effect.
  4. Following conversion from the XL formulation to the standard formulation, it is important to closely monitor blood pressure

There are two possible strategies to convert patients from modified release to standard doxazosin:

  • In elderly patients, give half the dose of Cardura XL as standard doxazosin, i.e. 4mg XL switched to 2mg standard od.  It may then be possible to increase the dose to 2mg bd.
  • In younger patients, give the same dose as Cardura XL divided into a bd regime i.e. 4mg XL to 2mg bd standard.

 Refer to BNF Chapter 7 for drugs used in the management of benign prostatic hyperplasia.

Please note, sample information has been entered into Chapters 1 and 2 only and although fairly clinically accurate, it is not guaranteed. The information was entered during April and May 2017 and drugs will have subsequently been randomly added during telephone demonstrations.

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See BNF chapter 7 for use in BPH

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