Table 11-10

*Table 11-10.* α-Adrenoceptor blocking agents, sympatholytics, and vasodilators.
Drug	Proprietary Name	Initial Dosage	Dosage Range	Cost per Unit	Cost of 30 Days Treatment (Average Dosage)¹	Adverse Effects	Comments
α-ADRENOCEPTOR BLOCKERS
Prazosin	Minipress	1 mg hs	2-20 mg in 2 or 3 doses	$0.78/5 mg	$46.80 (5 mg twice 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.
Terazosin	Hytrin	1 mg hs	1-20 mg in 1 or 2 doses	$1.60/1, 2, 5, 10 mg	$48.00 (5 mg daily)
Doxazosin	Cardura	1 mg hs	1-16 mg daily	$0.97/4 mg	$29.10 (4 mg daily)
CENTRAL SYMPATHOLYTICS
Clonidine	Catapres	0.1 mg twice daily	0.2-0.6 mg in 2 doses	$0.22/0.1 mg	$13.20 (0.1 mg twice daily)	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. Methyldopa should be avoided in favor of safer agents.
	Catapres TTS	0.1 mg/d patch weekly	0.1-0.3 mg/d patch weekly	$28.07/0.2 mg	$112.26 (0.2 mg weekly)
Guanabenz	Wytensin	4 mg twice daily	8-64 mg in 2 doses	$0.98/4 mg	$58.80 (4 mg twice daily)
Guanfacine	Tenex	1 mg once daily	1-3 mg daily	$0.87/1 mg	$26.10 (1 mg daily)
Methyldopa	Aldomet	250 mg twice daily	500-2000 mg in 2 doses	$0.63/500 mg	$37.80 (500 mg twice daily)

PERIPHERAL NEURONAL ANTAGONISTS

Reserpine	Serpasil	0.05 mg once daily	0.05-0.25 mg daily	$0.32/0.1 mg	$9.60 (0.1 mg daily)	Depression (less likely at low dosages, ie, < 0.25 mg), night terrors, nasal stuffiness, drowsiness, peptic disease, gastrointestinal disturbances, bradycardia.
DIRECT VASODILATORS
Hydralazine	Apresoline	25 mg twice daily	50-300 mg in 2-4 doses	$0.51/25 mg	$30.60 (25 mg twice daily)	GI disturbances, tachycardia, headache, nasal congestion, rash, LE-like syndrome.	May worsen or precipitate angina.
Minoxidil	Loniten	5 mg once daily	5-40 mg qd	$1.29/10 mg	$38.70 (10 mg qd)	Tachycardia, fluid retention, headache, hirsutism, pericardial effusion, thrombocytopenia.	Should be used in combination with β-blocker and diuretic.

¹Average wholesale price (AWP, for AB-rated generic when available) for quantity listed. Source: Red Book Update, Vol. 25, No. 1, January 20065. AWP may not accurately represent the actual pharmacy cost because wide contractual variations exist among institutions.

GI = gastrointestinal; LE = lupus erythematosus.

Table 11-10

*Table 11-10.* α-Adrenoceptor blocking agents, sympatholytics, and vasodilators.
Drug	Proprietary Name	Initial Dosage	Dosage Range	Cost per Unit	Cost of 30 Days Treatment (Average Dosage)¹	Adverse Effects	Comments
α-ADRENOCEPTOR BLOCKERS
Prazosin	Minipress	1 mg hs	2-20 mg in 2 or 3 doses	$0.78/5 mg	$46.80 (5 mg twice 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.
Terazosin	Hytrin	1 mg hs	1-20 mg in 1 or 2 doses	$1.60/1, 2, 5, 10 mg	$48.00 (5 mg daily)
Doxazosin	Cardura	1 mg hs	1-16 mg daily	$0.97/4 mg	$29.10 (4 mg daily)
CENTRAL SYMPATHOLYTICS
Clonidine	Catapres	0.1 mg twice daily	0.2-0.6 mg in 2 doses	$0.22/0.1 mg	$13.20 (0.1 mg twice daily)	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. Methyldopa should be avoided in favor of safer agents.
	Catapres TTS	0.1 mg/d patch weekly	0.1-0.3 mg/d patch weekly	$28.07/0.2 mg	$112.26 (0.2 mg weekly)
Guanabenz	Wytensin	4 mg twice daily	8-64 mg in 2 doses	$0.98/4 mg	$58.80 (4 mg twice daily)
Guanfacine	Tenex	1 mg once daily	1-3 mg daily	$0.87/1 mg	$26.10 (1 mg daily)
Methyldopa	Aldomet	250 mg twice daily	500-2000 mg in 2 doses	$0.63/500 mg	$37.80 (500 mg twice daily)

PERIPHERAL NEURONAL ANTAGONISTS

Reserpine	Serpasil	0.05 mg once daily	0.05-0.25 mg daily	$0.32/0.1 mg	$9.60 (0.1 mg daily)	Depression (less likely at low dosages, ie, < 0.25 mg), night terrors, nasal stuffiness, drowsiness, peptic disease, gastrointestinal disturbances, bradycardia.
DIRECT VASODILATORS
Hydralazine	Apresoline	25 mg twice daily	50-300 mg in 2-4 doses	$0.51/25 mg	$30.60 (25 mg twice daily)	GI disturbances, tachycardia, headache, nasal congestion, rash, LE-like syndrome.	May worsen or precipitate angina.
Minoxidil	Loniten	5 mg once daily	5-40 mg qd	$1.29/10 mg	$38.70 (10 mg qd)	Tachycardia, fluid retention, headache, hirsutism, pericardial effusion, thrombocytopenia.	Should be used in combination with β-blocker and diuretic.

GI = gastrointestinal; LE = lupus erythematosus.