Dofetilide is a white to off-white powder. Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, as well as concomitant illnesses. Not known whether terazosin is distributed into breast milk. Where can I get more information?
Extremely rarely, terazosin hydrochloride and similar medications have caused painful erection of the penis, sustained for hours and unrelieved by sexual intercourse or masturbation. This condition is serious, and if untreated it can be followed by permanent inability to have an erection. If you have a prolonged abnormal erection, call your doctor or go to emergency room as soon as possible. Lepor H, Meretyk S, Knapp-Maloney G. The safety, efficacy and compliance of terazosin therapy for benign prostatic hyperplasia. J Urol. Terazosin is to be used only by the patient for whom it is prescribed. Do not share it with other people. Do not use it for other health conditions.
Rapidly and almost completely absorbed from the GI tract following oral administration. 1 2 Peak plasma concentration attained in about 1 hour. Wing LMH, Reid CM, Ryan P, et al, for Second Australian National Blood Pressure Study Group. A comparison of outcomes with angiotensin-converting-enzyme inhibitors and diuretics for hypertension in the elderly. N Engl J Med. Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. Table 7 shows the incidence of serious arrhythmias and conduction disturbances reported as adverse events in the DIAMOND subpopulation that had AF at entry to these trials. Do not stop taking Tikosyn until your doctor tells you to stop. If you miss a dose, just take the next dose at your regular time. Do not take 2 doses of Tikosyn at the same time.
Ethinyl Estradiol; Norethindrone: Estrogen-containing oral contraceptive may induce fluid retention and may increase blood pressure in some patients taking antihypertensive agents. Such patients should be monitored to confirm that the desired antihypertensive effect is being obtained. Carbinoxamine; Phenylephrine: Sympathomimetics can antagonize the effects of antihypertensives such as alpha-blockers when administered concomitantly. Saunders E "The safety and efficacy of terazosin in the treatment of essential hypertension in blacks. There does not appear to be a benefit of stopping alpha-1 blocker therapy prior to cataract surgery. Ethinyl Estradiol; Norethindrone Acetate: Estrogen-containing oral contraceptive may induce fluid retention and may increase blood pressure in some patients taking antihypertensive agents. Such patients should be monitored to confirm that the desired antihypertensive effect is being obtained.
Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well. The overall systemic clearance of dofetilide is decreased and plasma concentration increased with decreasing creatinine clearance. The dose of Tikosyn must be adjusted based on creatinine clearance see . Patients undergoing dialysis were not included in clinical studies, and appropriate dosing recommendations for these patients are unknown. There is no information about the effectiveness of hemodialysis in removing dofetilide from plasma. Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. LDL, total cholesterol, and triglyceride concentrations. Alemtuzumab: Alemtuzumab may cause hypotension. Careful monitoring of blood pressure and hypotensive symptoms is recommended especially in patients with ischemic heart disease and in patients on antihypertensive agents. Patients should be closely followed during initial administration in order to minimize the risk of severe hypotensive response.
Carbetapentane; Pseudoephedrine: The cardiovascular effects of pseudoephedrine may reduce the antihypertensive effects produced by alpha-blockers. Monitor blood pressure and heart rate. It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding. In the DIAMOND studies, all patients were hospitalized for at least 3 days after treatment was initiated and monitored by telemetry. Even though you take terazosin hydrochloride and it may help you, terazosin hydrochloride may not prevent the need for surgery in the future. Not known whether terazosin is distributed into milk. 1 Caution if used in nursing women. Ethinyl Estradiol; Desogestrel: Estrogen-containing oral contraceptive may induce fluid retention and may increase blood pressure in some patients taking antihypertensive agents. Such patients should be monitored to confirm that the desired antihypertensive effect is being obtained. Because of this effect, your doctor may have told you to take terazosin hydrochloride at bedtime. If you take terazosin hydrochloride at bedtime but need to get up from bed to go to the bathroom, get up slowly and cautiously until you are sure how the medicine affects you. It is also important to get up slowly from a chair or bed at any time until you learn how you react to terazosin hydrochloride. You should not drive or do any hazardous tasks until you are used to the effects of the medication. If you begin to feel dizzy, sit or lie down until you feel better. Terazosin may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects. It is not known if Tikosyn is safe and effective in children under 18 years of age. Metabolic side effects have included decreases in serum triglycerides and VLDL cholesterol, and increases in HDL cholesterol. Terazosin may counterbalance deleterious effects on the lipid profile associated with thiazide diuretics, making it a reasonable drug to use in combination with these agents. This medicine may be harmful if swallowed. Terazosin also alters lipid metabolism, decreasing the levels of total cholesterol, low-density lipoprotein LDL cholesterol, and very low-density lipoprotein VLDL cholesterol. Significant changes were not observed in triglycerides and high-density lipoprotein. The implications of these changes are not known. Terazosin also does not worsen and may improve LVH, does not worsen insulin resistance, and causes only mild sexual dysfunction. Epoprostenol: Epoprostenol can have additive effects when administered with other antihypertensive agents, including alpha-blockers. These effects can be used to therapeutic advantage, but dosage adjustments may be necessary.
Ibuprofen lysine: NSAIDs may decrease the effect of antihypertensive agents through various mechanisms. Doses of antihypertensive medications may require adjustment in patients receiving concurrent NSAIDs. James PA, Oparil S, Carter BL et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee JNC 8. JAMA. Bauer JH. Stepped-care approach to the treatment of hypertension: is it obsolete? Tikosyn than placebo in patients with supraventricular arrhythmias: angioedema, bradycardia, cerebral ischemia, cerebrovascular accident, edema, facial paralysis, flaccid paralysis, heart arrest, increased cough, liver damage, migraine, myocardial infarct, paralysis, paresthesia, sudden death, and syncope. Cabergoline: Cabergoline has minimal affinity for adrenergic receptors; however, it has been associated with hypotension in some instances. Cabergoline should be used cautiously in those receiving antihypertensive agents or other medications known to cause hypotension. Chisholm GD. Benign prostatic hyperplasia: the best treatment. BMJ. Holtzman JL, Kaihlanen PM, Rider A et al. Concomitant administration of the terazosin and atenolol for the treatment of essential hypertension. Arch Intern Med. PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using terazosin while you are pregnant. It is not known if this medicine is found in breast milk. If you are or will be breast-feeding while you use terazosin, check with your doctor. Discuss any possible risks to your baby. Ethinyl Estradiol; Etonogestrel: Estrogen-containing oral contraceptive may induce fluid retention and may increase blood pressure in some patients taking antihypertensive agents. Such patients should be monitored to confirm that the desired antihypertensive effect is being obtained. Yellow 6 Imprinting ink: iron oxide black, shellac, n-butyl alcohol, isopropyl alcohol, propylene glycol, and ammonium hydroxide Listed trademarks are the property of their respective owners. Individualize dosage according to patient response and tolerance. 1 3 Initiate at low dosage to minimize frequency of postural hypotension and syncope. Serum potassium should be maintained within the normal range before Tikosyn treatment is initiated and should be maintained within the normal range while the patient remains on Tikosyn therapy. Chlorpheniramine; Dihydrocodeine; Pseudoephedrine: The cardiovascular effects of pseudoephedrine may reduce the antihypertensive effects produced by alpha-blockers. Monitor blood pressure and heart rate.
Deger G. Comparison of the safety and efficacy of once- daily terazosin versus twice-daily prazosin for the treatment of mild to moderate hypertension. Am J Med. Keep Tikosyn and all medicines out of the reach of children. Terazosin hydrochloride works by relaxing blood vessels so that blood passes through them more easily. This helps to lower blood pressure. Quinidine: Quinidine can decrease blood pressure and should be used cautiously in patients receiving antihypertensive agents due to the potential for additive hypotension. Carbetapentane; Guaifenesin; Phenylephrine: Sympathomimetics can antagonize the effects of antihypertensives such as alpha-blockers when administered concomitantly. The incidences of clinically significant laboratory test abnormalities in patients with supraventricular arrhythmias were similar for patients on Tikosyn and those on placebo. No clinically relevant effects were noted in serum alkaline phosphatase, serum GGT, LDH, AST, ALT, total bilirubin, total protein, blood urea nitrogen, creatinine, serum electrolytes calcium, chloride, glucose, magnesium, potassium, sodium or creatine kinase. Similarly, no clinically relevant effects were observed in hematologic parameters. Terazosin hydrochloride helps relieve the symptoms of BPH. It does NOT change the size of the prostate, which may continue to grow. However, a larger prostate does not necessarily cause more or worse symptoms. Possible drowsiness or somnolence; use caution when operating machinery or driving a motor vehicle until effects on individual are known. Do not share Terazosin capsules with anyone else; it was prescribed only for you. Your blood pressure or prostate will need to be checked often. Visit your doctor regularly. Procainamide: Procainamide can decrease blood pressure and should be used cautiously in patients receiving antihypertensive agents. Intravenous administration of procainamide is more likely to cause hypotensive effects. May take with food. Other side effects you could have while taking Terazosin capsules include drowsiness, blurred or hazy vision, nausea, or “puffiness” of the feet or hands. Discuss any unexpected effects you notice with your doctor. In geriatric patients, plasma clearance is decreased by about 30%. Hytrin, and shortly after taking the drug during the first week of treatment. Dispense in a tight, light-resistant container.
Avanafil: Concurrent use of avanafil and alpha-blockers may lead to symptomatic hypotension in some patients. Avanafil, a phosphodiesterase PDE5 inhibitor, and alpha-blockers are systemic vasodilators which can lower blood pressure. If vasodilators are used in combination, an additive effect on blood pressure is anticipated. Patients should be stable on alpha-blocker therapy before starting PDE5 inhibitor therapy. If hemodynamic instability is evident on alpha-blocker therapy alone, there is an increased risk of symptomatic hypotension with concomitant PDE5 inhibitor therapy. For patients who are stable on alpha-blocker therapy, PDE5 inhibitors should be started at the 50 mg dose. If a patient is currently receiving an optimized dose of a PDE5 inhibitor, alpha-blocker therapy should be initiated at the lowest dose. Stepwise increases in the alpha-blocker dose may be associated with further hypotension when taking a PDE5 inhibitor. Other variables, such as intravascular volume depletion and other antihypertensive drugs, may affect the safety of concomitant use of PDE5 inhibitors and alpha-blockers. Terazosin capsules, like other alpha-adrenergic blocking agents, can cause marked lowering of blood pressure, especially postural hypotension, and syncope in association with the first dose or first few days of therapy. A similar effect can be anticipated if therapy is interrupted for several days and then restarted. Syncope has also been reported with other alpha-adrenergic blocking agents in association with rapid dosage increases or the introduction of another antihypertensive drug. Syncope is believed to be due to an excessive postural hypotensive effect, although occasionally the syncopal episode has been preceded by a bout of severe supraventricular tachycardia with heart rates of 120 to 160 beats per minute. Additionally, the possibility of the contribution of hemodilution to the symptoms of postural hypotension should be considered. The prostate is a gland located below the bladder of men. It surrounds the urethra you-REETH-rah which is a tube that drains urine from the bladder. BPH is an enlargement of the prostate gland. The symptoms of BPH, however, can be caused by an increase in the tightness of muscles in the prostate. If the muscles inside the prostate tighten, they can squeeze the urethra and slow the flow of urine. This can lead to symptoms such as: What is BPH? It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs including any herbal medicines or supplements or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you. Dizziness; drowsiness; lightheadedness; nasal congestion; nausea; weakness. If therapy is interrupted for several days or longer, restart using initial dosage regimen. In hemodynamic studies, Tikosyn had no effect on cardiac output, cardiac index, stroke volume index, or systemic vascular resistance in patients with ventricular tachycardia, mild to moderate congestive heart failure or angina, and either normal or low left ventricular ejection fraction. There was no evidence of a negative inotropic effect related to Tikosyn therapy in patients with atrial fibrillation. There was no increase in heart failure in patients with significant left ventricular dysfunction see . In the overall clinical program, Tikosyn did not affect blood pressure. Prior to initiation of Tikosyn therapy, the patient should be advised to read the Medication Guide and reread it each time therapy is renewed in case the patient's status has changed. The patient should be fully instructed on the need for compliance with the recommended dosing of Tikosyn and the potential for drug interactions, and the need for periodic monitoring of QTc and renal function to minimize the risk of serious abnormal rhythms. This extra fluid in the makes the stool softer and easier to pass. Drink plenty of water when you use this type of laxative. Carbinoxamine; Dextromethorphan; Pseudoephedrine: The cardiovascular effects of pseudoephedrine may reduce the antihypertensive effects produced by alpha-blockers. Monitor blood pressure and heart rate. What happens if I overdose Hytrin? Chlorpheniramine; Hydrocodone; Phenylephrine: Sympathomimetics can antagonize the effects of antihypertensives such as alpha-blockers when administered concomitantly.
Niacin; Simvastatin: Cutaneous vasodilation induced by niacin may become problematic if high-dose niacin is used concomitantly with other antihypertensive agents. This effect is of particular concern in the setting of acute myocardial infarction, unstable angina, or other acute hemodynamic compromise. Some MEDICINES MAY INTERACT with terazosin. Hytrin terazosin hydrochloride is an alpha-adrenergic blocker used to treat and enlarged . Hytrin is available in form. If high blood pressure is not treated, over time, the increased pressure can damage blood vessels or it can cause the heart to work too hard and may decrease the flow of blood to the heart, brain, and kidneys. As a result, these organs may become damaged and not function correctly. If high blood pressure is controlled, this damage is less likely to happen. Cariprazine: Orthostatic vital signs should be monitored in patients who are at risk for hypotension, such as those receiving cariprazine in combination with antihypertensive agents. Atypical antipsychotics may cause orthostatic hypotension and syncope, most commonly during treatment initiation and dosage increases. Patients should be informed about measures to prevent orthostatic hypotension, such as sitting on the edge of the bed for several minutes prior to standing in the morning, or rising slowly from a seated position. Consider a cariprazine dose reduction if hypotension occurs. Garraway WM, Collins GN, Lee RJ. High prevalence of benign prostatic hypertrophy in the community. Lancet. National Heart, Lung, and Blood Institute. New analysis regarding the safety of calcium-channel blockers: a statement for health professionals from the National Heart, Lung, and Blood Institute. Dose reductions for reduced calculated creatinine clearance occurred in 47% and 45% of DIAMOND CHF and MI patients, respectively. Dose reductions for increased QT interval or QTc occurred in 5% and 7% of DIAMOND CHF and MI patients, respectively. Genitourinary complaints have rarely included impotence and priapism. This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects.
NSR for the 12 months duration of the studies. Selegiline: Additive hypotensive effects may be seen when monoamine oxidase inhibitors MAOIs are combined with antihypertensives. Careful monitoring of blood pressure is suggested during concurrent therapy with antihypertensives such as alpha-blockers. Patients should be instructed to rise slowly from a sitting position, and to report syncope or changes in blood pressure or heart rate to their health care provider. Terazosin hydrochloride is a white, crystalline substance, freely soluble in water and isotonic saline and has a molecular weight of 459. Deger G. Effect of terazosin on serum lipids. Am J Med. Articaine; Epinephrine: Sympathomimetics, such as epinephrine, can antagonize the effects of alpha-blockers when administered concomitantly. Patients receiving alpha-blockers can exhibit a decreased pressor response to epinephrine, resulting in an increased risk of developing hypotension and tachycardia. Blood pressure should be monitored closely.
Keep Tikosyn away from moisture and humidity. These adverse effects all occurred within 90 minutes of dosing. Rarely, probably less than once in every several thousand patients Terazosin and other α 1-antagonists have been associated with priapism painful penile erection, sustained for hours and unrelieved by sexual intercourse or masturbation. Two or three dozen cases have been reported. Syncope has occurred in less than 1% of patients. Palpitations have been reported in 5% of patients, but are much less likely than with some other alpha-adrenergic blockers. Peripheral edema, cold extremities, and chest pain have been reported in up to 6%, 12%, and 5% of patients, respectively. Atrial fibrillation has been reported incidence not given. If you miss a dose of terazosin, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. Tikosyn is indicated for the conversion of atrial fibrillation and atrial flutter to normal sinus rhythm. Terazosin capsules, USP are also indicated for the treatment of hypertension. Terazosin capsules, USP can be used alone or in combination with other antihypertensive agents such as diuretics or beta-adrenergic blocking agents.
Isoproterenol: Sympathomimetics can antagonize the effects of antihypertensives such as alpha-blockers when administered concomitantly. Acetaminophen; Dextromethorphan; Phenylephrine: Sympathomimetics can antagonize the effects of antihypertensives such as alpha-blockers when administered concomitantly. Therapy with Tikosyn must be initiated and, if necessary, re-initiated in a setting that provides continuous electrocardiographic ECG monitoring and in the presence of personnel trained in the management of serious ventricular arrhythmias. Patients should continue to be monitored in this way for a minimum of three days. Additionally, patients should not be discharged within 12 hours of electrical or pharmacological conversion to normal sinus rhythm. Ruoff G. Comparative trials of terazosin with other antihypertensive agents. Am J Med. Pain or vague discomfort during or after ejaculation. Hydrocodone; Phenylephrine: Sympathomimetics can antagonize the effects of antihypertensives such as alpha-blockers when administered concomitantly. If terazosin hydrochloride is helping you, you should notice an effect on your particular symptoms in 2 to 4 weeks of starting to take the medication. Terazosin hydrochloride administered as a capsule is essentially completely absorbed in man. Administration of capsules immediately after meals had a minimal effect on the extent of absorption. The time to reach peak plasma concentration however, was delayed by about 40 minutes. Terazosin has been shown to undergo minimal hepatic first-pass metabolism and nearly all of the circulating dose is in the form of parent drug. The plasma levels peak about one hour after dosing, and then decline with a half-life of approximately 12 hours. Terazosin Capsules, USP Can Cause a Sudden Drop in Blood Pressure After the VERY FIRST DOSE. You may feel dizzy, faint, or “light-headed” particularly after you get up from bed or from a chair. OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional. Roberts RG. Novel idea in BPH guideline: the patient as decision maker. Am Fam Physician. Number of patients evaluated for QTc change: 478 Tikosyn, 167 placebo. What is a laxative? General anesthetics: General anesthetics can potentiate the hypotensive effects of antihypertensive agents.
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In healthy volunteers, amlodipine, phenytoin, glyburide, ranitidine, omeprazole, hormone replacement therapy a combination of conjugated estrogens and medroxyprogesterone antacid aluminum and magnesium hydroxides and theophylline did not affect the pharmacokinetics of Tikosyn. In addition, studies in healthy volunteers have shown that Tikosyn does not affect the pharmacokinetics or pharmacodynamics of warfarin, or the pharmacokinetics of propranolol 40 mg twice daily phenytoin, theophylline, or oral contraceptives. What are the possible side effects of Tikosyn? Dextromethorphan; Guaifenesin; Phenylephrine: Sympathomimetics can antagonize the effects of antihypertensives such as alpha-blockers when administered concomitantly.
In a study of 226 patients on terazosin for up to 2 years, only 2 discontinued therapy due to rash. Dizziness, lightheadedness, or sudden fainting may occur after you take terazosin, especially when you get up from a lying or sitting position. These effects are more likely to occur when you take the first dose of terazosin. Taking the first dose at bedtime may prevent problems. However, be especially careful if you need to get up during the night. These effects may also occur with any doses you take after the first dose. Getting up slowly may help lessen this problem. If you feel dizzy, lie down so that you do not faint. Then sit for a few moments before standing to prevent the dizziness from returning.
Torsade de Pointes is the only arrhythmia that showed a dose-response relationship to Tikosyn treatment. It did not occur in placebo treated patients. Important: The opinions expressed in WebMD User-generated content areas like communities, reviews, ratings, blogs, or WebMD Answers are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. User-generated content areas are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions.
Using terazosin and metoprolol together can have increased effects on your blood pressure. You may be more likely to experience side effects such as dizziness, weakness, headache, flushing, fainting, and irregular heartbeat, especially if you have been on metoprolol and are starting treatment with terazosin. These effects may also occur following a dose increase of terazosin or when terazosin is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. You may need a dose adjustment or more frequent monitoring of your blood pressure to safely use both medications. Taking the terazosin dose just before going to bed may help. Avoid driving or operating hazardous machinery until you know how these medications affect you, and use caution when getting up from a sitting or lying position. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.