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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 two to four 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 four to six 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 http://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 http://dailymed.nlm.nih.gov/dailymed/about.cfm.

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