Alpha-1-receptor antagonists used to treat lower urinary tract symptoms due to benign prostatic hyperplasia (BPH)

Medication	Dose^*		Administration
Alfuzosin (Uroxatral, Xatral)	Initial and maintenance	10 mg	Once daily immediately following a meal at the same time each day
Silodosin (Rapaflo)	Initial and maintenance	8 mg	Once daily with a meal at the same time each day
Tamsulosin (Flomax)	Initial and maintenance	0.4 mg	Once daily approximately 30 minutes after a meal at the same time each day; 0.8 mg dose may be administered as 0.4 mg twice daily
Tamsulosin (Flomax)	If inadequate response after 2 to 4 weeks	0.8 mg
Tamsulosin extended-release (Flomax CR) (NOTE: formulation available in some countries other than the United States)	Initial and maintenance	0.4 mg	Once daily with a meal at the same time each day; maximum dose 0.4 mg once daily
Conventional agents: Titration recommended to reduce orthostatic effects Dose is advanced as shown if patient remains symptomatic and is tolerating current dose
Doxazosin immediate-release (Cardura)	Days 1 to 3	1 mg	Once daily at bedtime
	Days 4 to 14	2 mg
	Weeks 2 to 6	4 mg
	Week 7 and thereafter	8 mg
Doxazosin extended-release (Cardura XL)	Days 1 to 21	4 mg	Once daily with morning meal
Doxazosin extended-release (Cardura XL)	Week 4 and thereafter	8 mg	Once daily with morning meal
Terazosin (Hytrin)	Standard titration (appropriate for most patients)
	Days 1 to 3	1 mg	Once daily at bedtime
	Days 4 to 14	2 mg
	Weeks 2 to 6	5 mg
	Week 7 and thereafter	10 mg
	If inadequate response after 4 to 6 weeks of 10 mg/day	20 mg
	Rapid titration (for selected patients)
	Days 1 to 3	1 mg	Once daily at bedtime
	Days 4 to 14	2 mg
	Weeks 2 to 3	5 mg
	Week 4 and thereafter	10 mg
	If inadequate response after 4 to 6 weeks of 10 mg/day	20 mg

Dosing recommendations are for oral administration in adult patients with normal organ function. Titration schedules are examples; other regimens may be appropriate. For recommendations on clinical use and individualizing drug selection, refer to the clinical topic review of BPH and individual drug information topics.
Alpha-1-receptor antagonists may have additive hypotensive effects with phosphodiesterase-5 inhibitors (eg, sildenafil) and other agents that lower blood pressure. For specific drug interactions, refer to the Lexicomp drug interactions database included within UpToDate.
Dosing recommendations for other agents used to treat lower urinary tract symptoms due to BPH is available in a separate table within UpToDate.

* If therapy is interrupted for 3 or more days, reinitiate at lowest dose and retitrate according to schedule.

Data from:

Lee M. Management of benign prostatic hyperplasia. In: Pharmacotherapy, 7th ed, Dipiro JT, Talbert RL, Yee GC, et al (Eds), McGraw-Hill Medical 2008.
AUA Practice Guidelines Committee. AUA guideline on management of benign prostatic hyperplasia (2003). Chapter 1: Diagnosis and treatment recommendations. J Urol 2003; 170:530.

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Alpha-1-receptor antagonists used to treat lower urinary tract symptoms due to benign prostatic hyperplasia (BPH)