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©2013 UpToDate ® Print Email Alpha-1 receptor antagonist for BPH* Dose titration schedule to reduce orthostatic effects [1] Terazosin standard (appropriate for most patients) Days 1 to 3 1 mg Days 4 to 14 2 mg Weeks 2 to 6 5 mg Weeks 7 and thereafter 10 mg Terazosin rapid (for selected patients) Days 1 to 3 1 mg Days 4 to 14 2 mg Weeks 2 to 3 5 mg Weeks 4 and thereafter 10 mg Doxazosin (immediate release) Days 1 to 3 1 mg Days 4 to 14 2 mg Weeks 2 to 6 4 mg Weeks 7 and thereafter 8 mg Doxazosin (extended release preparation only) Days 1 to 21 4 mg Week 4 and thereafter 8 mg Uroselective Alpha-1 receptor antagonists [2] • Alfuzosin Initial and maintenance 10 mg Tamsulosin Initial and maintenance 0.4 mg If inadequate response after 2-4 weeks 0.8 mg Silodosin Initial and maintenance 8 mg BPH: benign prostatic hyperplasia. * Titrate dose as tolerated and as needed for effect. Oral administration for all medications is once daily at bedtime. Peak effect of a given dose on BPH symptoms may not be fully evident until 4 to 6 weeks. If therapy is interrupted for three or more days, reinitiate at lowest dose and re-titrate according to schedule. • Due to lower risk of orthostatic hypotension and syncope, uroselective agents do not require gradual dose titration. Oral administration for all medications is once daily at bedtime. 1. Data from: US FDA approved product information accessed at file://dailymed.nlm.nih.gov/dailymed/about.cfm and Lee, M Management of benign prostatic hyperplasia chap 87 in Pharmacotherapy 7th ed Dipiro, JT, Talbert, RL, Yee, GC et al. 2008; McGraw Hill Medical. 2. Data from: US FDA approved product information accessed at file://dailymed.nlm.nih.gov/dailymed/about.cfm.