- Side Effects
- Drug Interactions
- What Else to Know
- Pregnancy & Breastfeeding
Generic Name: prazosin
Brand Name: Minipress
Drug Class: Alpha Blockers, Antihypertensives
What is prazosin, and what is it used for?
Prazosin is an antihypertensive medication used in the treatment of high blood pressure (hypertension), either alone or in combination with other antihypertensive drugs such as diuretics or beta blockers. Prazosin reduces blood pressure by relaxing the smooth muscles around blood vessels, dilating them and improving blood flow. Prazosin is also used off-label in the treatment of enlarged prostate (benign prostate hyperplasia), posttraumatic stress disorder (PTSD), and Raynaud’s phenomenon.
Prazosin is derived from a chemical known as quinazoline and belongs to the alpha blocker class of medications. Prazosin binds to alpha-1 receptors, protein molecules on smooth muscles, and prevents their stimulation by the hormones (catecholamines) epinephrine and norepinephrine, which makes the smooth muscles contract. Alpha-1 receptors are present in the smooth muscles of blood vessel walls, prostate, urethra, iris dilator muscle, and the brain.
Prazosin improves urinary flow in patients with benign prostate hyperplasia by relaxing the smooth muscles in the bladder neck and prostate. Vasodilation improves peripheral blood flow in patients with Raynaud’s phenomenon, a condition that causes poor circulation in the extremities. Prazosin crosses the blood-brain barrier and inhibits hyperarousal states by catecholamine activity in the brain, reducing PTSD-related insomnia and nightmares.
- Do not administer prazosin to patients with known sensitivity to quinazoline, prazosin or any of its components
- Discontinue prazosin if the patient has onset or worsening of chest pain (angina)
- Prazosin may exacerbate heart failure; use with caution
- Prazosin can cause temporary loss of consciousness (syncope) due to vasodilation and drop in blood pressure, especially in the first 30-90 minutes after the first dose; keep the patient lying flat and treat with supportive care as necessary
- Can cause syncope and orthostatic hypotension when first administered after an interruption of therapy or when administered with other vasodilators such as beta blockers or phosphodiesterase-5 (PDE-5) inhibitors; exercise caution
- May cause central nervous system (CNS) depression; caution patients appropriately
- May aggravate symptoms in patients with narcolepsy sleep disorder
- May cause prolonged and painful erections (priapism); advise patients appropriately
- Rule out prostate cancer before initiating prazosin therapy
- Intraoperative floppy iris syndrome has been reported during cataract surgery in some patients treated with alpha-1 blockers; use appropriate technique
What are the side effects of prazosin?
Common side effects of prazosin include:
Less common side effects of prazosin include:
- Dry mouth (xerostomia)
- Swelling (edema)
- Shortness of breath (dyspnea)
- Drop in blood pressure when standing from sitting or lying down (orthostatic hypotension)
- Fainting (syncope)
- Urinary frequency
- Nasal congestion
- Nasal bleeding (epistaxis)
- Blurred vision
- Red eye
Rare side effects of prazosin include:
- Abdominal discomfort and/or pain
- Liver function abnormalities
- Pancreas inflammation (pancreatitis)
- Rapid heart rate (tachycardia)
- Chest pain (angina pectoris)
- Low blood pressure (hypotension)
- Slow heart rate (bradycardia)
- Sleeplessness (insomnia)
- Abnormal skin sensations (paresthesia)
- Ringing in the ears (tinnitus)
- Eye pain
- Allergic reaction
- Hives (urticaria)
- Itching (pruritus)
- Lichen planus
- Autoimmune reaction (positive ANA titer)
- Hair loss (alopecia)
- Prolonged and painful erection (priapism)
- Excessive sweating (diaphoresis)
- Joint pain (arthralgia)
- Feeling unwell (malaise)
- Generalized pain
- Blood vessel inflammation (vasculitis)
- Breast tissue growth in males (gynecomastia)
- Intraoperative floppy iris syndrome during cataract surgery, because of relaxation of iris dilator muscle
This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug.
Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.
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What are the dosages of prazosin?
- 1 mg
- 2 mg
- 5 mg
- Initial: 1 mg orally every 8-12 hours
- Maintenance: 6-15 mg/day divided 2 or 3 times daily; alternatively, 1-5 mg orally twice daily; may increase the dose to 20 mg/day in divided doses; some patients may benefit from up to 40 mg/day in divided doses
PTSD-Related Nightmares and Sleep Disruption (off label)
- Initial: 1 mg orally at bedtime
- Maintenance: 1 mg orally at bedtime initially; may increase the dose to 2 mg at bedtime; adjust dose based on response and tolerability in 1-2 mg increments every 7 days; not to exceed 15 mg/day
Benign Prostate Hypertrophy (off label)
- Initial: 0.5 mg orally every 12 hours
- Maintenance: 2 mg orally every 12 hours
Raynaud Phenomenon (off label)
- 0.5-1 mg orally each day (at bedtime) or 0.5 mg orally twice daily; adjust dose based on response and tolerability up to 12 mg/day divided twice daily/three times daily
- Give first dose and subsequent increases at bedtime to avoid syncope
- Okay with food
- Avoid use for hypertension; high risk of orthostatic hypotension (Beers criteria)
- May cause significant orthostatic hypotension and syncope; consider lower initial dose; titrate to response
- Adverse effects such as dry mouth and urinary complications can be bothersome in the elderly
Hypertension (off label)
- Initial: 0.05-0.1 mg/kg/day orally divided every 8 hours
- Titrate to 0.5 mg/kg/day; not to exceed 20 mg/day
- Okay with food
- Prazosin overdose may cause drowsiness, depressed reflexes, and low blood pressure (hypotension).
- Overdose is treated with symptomatic and supportive care, including increasing the blood volume and normalization of blood pressure with vasopressor medications.
- In case of overdose, seek medical help immediately or contact Poison Control.
What drugs interact with prazosin?
Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.
- Prazosin has no known severe interactions with other drugs.
- Serious interactions of prazosin include:
- Prazosin has moderate interactions with at least 99 different drugs.
- Mild interactions of prazosin include:
The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.
It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.
What else should I know about prazosin?
- Take prazosin exactly as prescribed
- Keep safely out of reach of children
- You may have dizziness or drowsiness especially after the first dose or after a dose increase; avoid driving and tasks that require physical and mental alertness for the first 24 hours until the effects of the drug can be determined
- Getting up slowly may help reduce lightheadedness that you may feel when standing up from sitting or lying down
- Drinking alcohol, dehydration, exercise or standing for long periods can also cause dizziness and fainting; exercise caution
- Seek medical help in case of prolonged and painful erections
Pregnancy and breastfeeding
- Limited studies of prazosin use to treat hypertension during pregnancy have not revealed any fetal or neonatal harm; however, there are no adequate and well-controlled studies in pregnant women.
- Use during pregnancy if potential benefits to the mother outweighs potential risk to the mother and fetus.
- Prazosin is excreted in breast milk in small amounts; use with caution in nursing mothers.
Prazosin is an antihypertensive medication used in the treatment of high blood pressure (hypertension), either alone or in combination with other antihypertensive drugs such as diuretics or beta blockers. Prazosin is also used off-label in the treatment of enlarged prostate (benign prostate hyperplasia), posttraumatic stress disorder (PTSD), and Raynaud’s phenomenon. Common side effects of prazosin include dizziness, headache, drowsiness, fatigue, weakness (asthenia), palpitations, and nausea. Consult your doctor before taking prazosin if pregnant or breastfeeding.
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What Is the Normal Blood Pressure Range?
Blood pressure is the force applied by the blood over the inner walls of the arteries. Although the average blood pressure for a person remains constant, it shows minor fluctuations throughout the day—declining while relaxing and momentarily increasing while being excited or under stress. An increase in resting blood pressure can scar, stiffen, or harden the arteries.
How to Lower My Blood Pressure Immediately
If you face any complications of high blood pressure such as a stroke or heart attack, contact your physician without any delay. Do not attempt home remedies in such grave situations. If you have high blood pressure, without any complications, the first thing to do is to calm down and lie flat.
Why Is My Bottom Blood Pressure Number High?
Isolated diastolic hypertension (IDH) occurs when your systolic blood pressure is normal, and only your diastolic blood pressure is high (over 80 mm Hg). Causes of high diastolic blood pressure include a high-sodium diet, obesity, lack of physical activity, excessive alcohol consumption, stress and anxiety.
High Blood Pressure (Hypertension)
High blood pressure (hypertension) is a disease in which pressure within the arteries of the body is elevated. About 75 million people in the US have hypertension (1 in 3 adults), and only half of them are able to manage it. Many people do not know that they have high blood pressure because it often has no has no warning signs or symptoms. Systolic and diastolic are the two readings in which blood pressure is measured. The American College of Cardiology released new guidelines for high blood pressure in 2017. The guidelines now state that blood normal blood pressure is 120/80 mmHg. If either one of those numbers is higher, you have high blood pressure. The American Academy of Cardiology defines high blood pressure slightly differently. The AAC considers 130/80 mm Hg. or greater (either number) stage 1 hypertension. Stage 2 hypertension is considered 140/90 mm Hg. or greater. If you have high blood pressure you are at risk of developing life threatening diseases like stroke and heart attack.REFERENCE: CDC. High Blood Pressure. Updated: Nov 13, 2017.
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What Is Normal Blood Pressure and Pulse by Age?
The American Heart Association outlines that a normal blood pressure reading of 120/80 mm Hg for adults. Here is a chart that breaks down the ideal blood pressure range by age.
What Is Considered Stroke-Level High Blood Pressure?
Blood pressure readings above 180/120 mmHg are considered stroke-level, dangerously high, and require immediate medical attention.
Is 120 Over 60 a Good Blood Pressure Reading?
If your systolic blood pressure is normal (between 100-120), and your diastolic blood pressure is lower (60 or below), you are considered to have low blood pressure, or isolated diastolic hypotension. Low diastolic blood pressure should be monitored closely.
What Is Normal Blood Pressure for a 60-Year-Old?
According to current guidelines from the American Heart Association, normal blood pressure for adults under the age of 65 is any blood pressure below 120/80 mmHg.
What Does it Mean When the Bottom Number of Your Blood Pressure is Over 100?
Diastolic blood pressure (DBP) is the pressure exerted on the walls of the arteries when the heart muscle relaxes between beats. When the bottom number of blood pressure (diastole) is over 100 mmHg, it may be called diastolic hypertension (DHT). Diastolic blood pressure means the blood pressure reading during the phase when your heart relaxes (diastole). Force of the blood against the walls of the arteries (the blood vessels carrying blood from the heart to other sites) in the body is called blood pressure. The heart pumps the blood into the arteries as it contracts (systole).
Is 110/60 a Too Low Blood Pressure?
A blood pressure reading of 110/60 mmHg is usually not considered a low blood pressure.
How Do You Check Your Blood Pressure With Your Fingers?
Most doctors recommend the use of a blood pressure machine to check blood pressure. An individual may check heart rate with their fingers, but not blood pressure.
What Causes Low Diastolic Blood Pressure?
A diastolic blood pressure (DBP) of somewhere between 60 and 90 mm Hg is good in older people. Causes of low DBP include bed rest, dehydration, loss of water, alcohol use, hormone deficiencies, allergic reactions, nutritional deficiencies and prolonged standing leading to blood pooling in the legs.
Is 150 Over 90 a Good Blood Pressure?
Blood pressure of 150/90 mmHg comes under the category of stage I hypertension and means that you have high blood pressure.
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How Is Diastolic Hypertension Treated?
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Can You Take Turmeric with Blood Pressure Medication?
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Can Drinking Water Lower Your Blood Pressure?
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Which Blood Pressure Number Is the Most Important?
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Which Is More Important: Systolic or Diastolic Blood Pressure?
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Hypertensive Kidney Disease
High blood pressure can damage the kidneys and is one of the leading causes of kidney failure (end-stage renal kidney disease). Kidney damage, like hypertension, can be unnoticeable and detected only through medical tests. If you have kidney disease, you should control your blood pressure. Other treatment options include prescription medications.
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Can High Blood Pressure (HBP) Cause Blood in Urine?
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Can High Blood Pressure Hurt My Eyes?
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Pseudotumor Cerebri (Idiopathic Intracranial Hypertension)
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Can I Check My Blood Pressure With My Phone?
The force of the blood against the walls of the blood vessels carrying blood from the heart to other sites in the body (the arteries) is called blood pressure. The heart pumps blood into the arteries as it contracts (systole).
What Is “Normal” Blood Pressure?
Normal blood pressure is when the pressure is less than or upto 120/80 mmHg. The value 120 denotes the systolic pressure, and the value 80 denotes the diastolic pressure.
What Are the New Blood Pressure Guidelines for Seniors?
Hypertension or high blood pressure (high BP) is a medical condition where the pressure in the blood vessels is persistently elevated. The heart pumps blood into the arteries, which circulate blood to all parts of the body. In cases of high blood pressure, the heart has to work harder to push the blood column ahead.
Preeclampsia (Pregnancy Induced Hypertension)
Preeclampsia is related to increased blood pressure and protein in the mother's urine. Preeclampsia typically begins after the 20th week of pregnancy. When preeclampsia causes seizures, it is termed "eclampsia" and is the second leading cause of maternal death of in the US. Preeclampsia is the leading cause of fetal complications. Risk factors for preeclampsia include high blood pressure, obesity, multiple births, and women with preexisting medical conditions such as diabetes, kidney disease, rheumatoid arthritis, lupus, or scleroderma. Pregnancy planning and lifestyle changes may reduce the risk of preeclampsia during pregnancy.
High Blood Pressure Symptoms
Most people with high blood pressure have no signs or symptoms, even if blood pressure readings reach dangerously high levels. In some patients, symptoms may include fatigue, headaches, dizziness, confusion, sweating, chest pain and vision problems.
What Is the Proper Way to Take Your Blood Pressure?
Nowadays, you can easily measure your blood pressure at home using an automated blood pressure machine or sphygmomanometer. Here’s how to do it step-by-step to make sure you’re doing it the right way.
Hypertension-Induced Chronic Kidney Disease
Hypertension-induced chronic kidney disease (CKD) is a long-standing kidney condition that develops over time due to persistent or uncontrolled high blood pressure (hypertension).
How Does High Blood Pressure Affect Pregnancy?
High blood pressure during pregnancy can cause serious complications. Learn more about the signs of and risks associated with the condition.
What Is a Normal Blood Pressure Check?
A normal blood pressure check should be below 120/80 mmHg in adults (18 years and older).
What Is the Drug of Choice for Hypertension?
Angiotensin-converting enzyme (ACE) inhibitors are the drug of choice for hypertension. Learn about other high blood pressure medications.
What Is High Blood Pressure (Hypertension)?
High blood pressure or hypertension is when the blood pressure readings consistently range from 140 or higher for systolic or 90 or higher for diastolic. Blood pressure readings above 180/120 mmHg are dangerously high and require immediate medical attention.
How Often Should Blood Pressure be Checked?
People older than 40 years should check their blood pressure once a year, while those between 18 and 40 years old should check it every three to five years.
Is Pseudotumor Cerebri the Same as Intracranial Hypertension?
Pseudotumor cerebri (PTC) is also called idiopathic intracranial hypertension (IIH). The condition causes symptoms similar to a brain tumor.
What Causes High Blood Pressure in Children?
Research states that kidney disease is the main cause of high blood pressure in children; however, here are the other potential causes of hypertension in kids.
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