Find Prescription Drugs, Brand and Generic Medications, from our International Prescription Service. Can't find the medication you're looking for? Also, the exact same medication may have a different trade name in Canada or around the world. Please remember that there are always two names for every prescription drug, the brand or trade name, and the chemical or generic name. Searching for both the brand and the chemical name will produce a more thorough search of the database. To minimize your drug costs, we can substitute with a generic drug where applicable. Generic drugs are lower cost alternatives to the brand product but are made by a generic company, thus lowering the price and saving you money. Any generic drug dispensed has been approved by the health regulatory authority where the drug is licensed. The quantities listed in the price quote system indicate the quantity in the manufacturer's sealed package. We will ship in the manufacturer's sealed packages. We are not allowed by law to ship controlled substances such as Valium or narcotics such as Codeine. Due to increases in drug cost by the manufacturer and/or fluctuations in the exchange rate between the Canadian and U. Find Prescription Drugs, Brand and Generic Medications, from our International Prescription Service.Cardura (doxazosin mesylate) dose, indications, adverse effects, interactions.. NOTE: A landmark clinical trial (ALLHAT) compared doxazosin to chlorthalidone in the treatment of high- risk hypertensive patients. In this study, only the diuretic significantly reduced the risk of combined cardiovascular disease events, especially heart failure; doxazosin did not. These results led to discontinuation of the doxazosin treatment arm of the study. NOTE: Doxazosin extended- release tablets are not FDA- approved for the treatment of hypertension. Oral dosage (immediate- release tablets)Adults Initially, 1 mg PO once daily at bedtime. Adjust dosage based on clinical response. Dosage may be increased every several days as necessary depending on the patients standing blood pressure response, however, the long half- life of doxazosin should be considered when titrating the dosage. Maximum daily dose is 1. Geriatric See adult dosage. Geriatric patients may be more sensitive to the hypotensive effects of doxazosin. Adjust dosage based on clinical response. For the treatment of benign prostatic hyperplasia (BPH). For treatment of BPH in combination with finasteride. Oral dosage. Adult males The role of doxazosin for this purpose has not been established. Information about the drug doxazosin mesylate (Cardura, Cardura XL), a medication prescribed for the treatment of high blood pressure (hypertension), and enlarged. Initially, 1 mg PO once daily at bedtime; adjust based on response, up to 8 mg PO once daily at bedtime. In a long- term, double- blind clinical trial of 3,0. BPH, combination therapy of doxazosin (4 to 8 mg/day PO) and finasteride (5 mg/day PO) was shown to significantly reduce the risk of overall clinical progression of BPH than either drug alone. However, based on a study of finasteride alone, more data are needed to confirm that finasteride has positive overall effects in delaying or reducing the incidence of prostate cancer. Geriatric males See adult dosage. Geriatric patients may be more sensitive to the hypotensive effects of doxazosin. Adjust dosage based on clinical response. Oral dosage (immediate- release tablets)Adult males Initially, 1 mg PO once daily at bedtime. Adjust dosage based on clinical response. Dosage may be increased up to 8 mg PO once daily at bedtime. Geriatric males See adult dosage.
Geriatric patients may be more sensitive to the hypotensive effects of doxazosin. Adjust dosage based on clinical response. Oral dosage (extended- release tablets, Cardura XL)Adult males Initially, 4 mg PO once daily, taken with breakfast. Adjust dosage in 3 to 4 weeks based on clinical response. Dosage may be increased up to 8 mg PO once daily. If therapy is interrupted for several days, initiate dosage at the starting dose of 4 mg PO once daily. If switching from immediate- release doxazosin tablets, initiate dosage with the extended- release tablets at the starting dose of 4 mg PO once daily. Prior to starting therapy with the extended- release tablets, the final evening dose of the immediate- release tablets should not be taken. Geriatric males See adult dosage. Geriatric patients may be more sensitive to the hypotensive effects of doxazosin. Adjust dosage based on clinical response. MAXIMUM DOSAGEAdults. PO for hypertension and 8 mg/day PO for benign prostatic hyperplasia (BPH). Elderly. 16 mg/day PO for hypertension and 8 mg/day PO for benign prostatic hyperplasia (BPH). Adolescents. Safety and efficacy have not been established. Children. Safety and efficacy have not been established. DOSING CONSIDERATIONSHepatic Impairment. No specific recommendations are available for hepatic disease. Since doxazosin is extensively metabolized, it is prudent to start with the lowest initial adult dosage (1 mg PO once daily in the morning or at bedtime). Adjust dosage based on response. Renal Impairment. No dosage adjustment is needed. Intermittent hemodialysis. No dosage adjustment is needed; doxazosin is highly protein bound and is not removed during hemodialysis. ADMINISTRATIONOral Administration. Observe for postural hypotension, particularly with first dose. Oral Solid Formulations. Immediate- release tablets: May be administered orally without regard to meals. Extended- release tablets (Cardura XL): Administer once daily with breakfast. NOTE: Prior to starting therapy with the extended- release tablets, the final evening dose of the immediate- release tablets should not be taken. STORAGECardura: - Store between 6. F, excursions permitted 5. FCardura XL: - Store at 7. F; excursions permitted to 5. FCONTRAINDICATIONS / PRECAUTIONSGeneral Information. Doxazosin is contraindicated in patients with a hypersensitivity to doxazosin, other quinazolines (e. Hypotension, orthostatic hypotension, syncope Doxazosin must be used with caution, especially with initial dosing, as hypotension may occur. Blood pressure should be monitored for 2 to 6 hours following the first dose (e. Dosages should be adjusted as necessary depending on patient tolerance as evidenced by standing blood pressure. Doxazosin should not be administered to any patient who has existing hypotension (including orthostatic hypotension or syncope). Hepatic disease. Doxazosin should be used with caution in patients with hepatic disease because the drug is primarily metabolized by the liver. Exaggerated effects could occur after normal doses of drug in these patients. Pregnancy There are insufficient data regarding the use of doxazosin in pregnant women to determine if a drug- associated risk for major birth defects and miscarriage exists. However, untreated hypertension during pregnancy can result in increased maternal risks including pre- eclampsia, gestational diabetes, premature delivery, and delivery complications. Hypertension also increases the risk for fetal intrauterine growth restriction and intrauterine death. In animal reproduction studies, no adverse developmental effects were observed when doxazosin was orally administered at doses 4 to 1. AUC exposures. Breast- feeding There are no data regarding the effects of doxazosin on the breast- fed infant or on milk production. Although the data are insufficient to confirm the presence of doxazosin in human milk, a single case study involving a breast- feeding mother receiving doxazosin reports an infant exposure of doxazosin of < 1% of the maternal weight- adjusted dosage and a milk: plasma ratio of 0. Ocular surgery. Patients receiving or who have previously received treatment with doxazosin or other alpha- 1 blockers may be at risk for intraoperative floppy iris syndrome during ocular surgery for cataracts. Intraoperative floppy iris syndrome is a small pupil syndrome variant that is characterized by a flaccid iris that billows in response to intraoperative irrigation currents, progressive intraoperative miosis despite preoperative dilation with standard mydriatic drugs, and potential prolapse of the iris toward the phacoemulsification incisions. There does not appear to be a benefit of stopping alpha- 1 blocker therapy prior to cataract surgery, but ophthalmologists should be prepared for possible modifications to their surgical technique such as the use of iris hooks, iris dilator rings, or viscoelastic substances. Priapism Rarely, doxazosin, like other alpha adrenergic antagonists, has been associated with priapism (persistent painful penile erection unrelated to sexual activity). Priapism, if not treated promptly, can result in irreversible damage to the erectile tissue. Patients who have an erection lasting greater than 4 hours, whether painful or not, should seek emergency medical attention. Geriatric Insufficient data are available from hypertension clinical trials to determine a difference between the effects of doxazosin in geriatric vs. Geriatric patients may be more likely to be susceptible to hypotensive effects at the usual adult dosage, particularly with initial dosing or an increase in dose, when postural hypotensive effects and orthostasis are more likely to occur (e. The safety and effectiveness profile of doxazosin for benign prostatic hypertrophy (BPH) was similar in older male patients 6. According to the Beers Criteria, doxazosin is considered a potentially inappropriate medication (PIM) for use in geriatric patients and is not recommended as routine treatment of hypertension in this population due to the high risk of orthostatic hypotension and the availability of alternative agents with a superior benefit to risk profile. In addition, the Beers expert panel recommends avoiding doxazosin in geriatric patients with syncope due to an increased risk of orthostatic hypotension or bradycardia, and also avoiding doxazosin in geriatric females with urinary incontinence, regardless of cause or type, because aggravation of incontinence may occur. The federal Omnibus Budget Reconciliation Act (OBRA) regulates medication use in residents of long- term care facilities (LTCFs). According to the OBRA guidelines, antihypertensive regimens should be individualized to achieve the desired outcome while minimizing adverse effects. Antihypertensives may cause dizziness, postural hypotension, fatigue, and there is an increased risk for falls. Doxazosin can cause significant hypotension and syncope during the first few doses; therefore, the dose should be administered at bedtime initially, and the drug slowly titrated as needed. There are many drug interactions that can potentiate the effects of antihypertensives. Some agents require a gradual taper to avoid adverse consequences caused by abrupt discontinuation. In addition, when doxazosin is infrequently used as a treatment for urinary incontinence, assessment of the underlying causes and identification of the type/category of urinary incontinence needs to be documented prior to or soon after the time of initiating treatment. These medications have specific and limited indications based on the cause and categorization of incontinence. Patients should be assessed periodically for medication effects on urinary incontinence as well as lower urinary tract symptoms and treatment tolerability. ADVERSE REACTIONSSeverevisual impairment / Early / 1.
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