CARDURA 2MG TABS 28`S

Cardura (doxazosin) belongs to a class of medicines called alpha-1 blockers. It has two distinct clinical uses: reducing high blood pressure (hypertension) and relieving the urinary symptoms of an enlarged prostate gland (benign prostatic hyperplasia or BPH). By relaxing smooth muscle in blood vessel walls and in the prostate and bladder neck, doxazosin improves both blood pressure control and urinary flow.

Cardura does not shrink the prostate or cure hypertension — it controls symptoms and reduces cardiovascular risk over the long term.

Approved Uses

•     Hypertension (high blood pressure) — to reduce the risk of stroke, heart attack, and kidney disease

•     Benign prostatic hyperplasia (BPH) — to relieve symptoms including: weak urine stream, difficulty starting urination, frequent urination (especially at night), and incomplete bladder emptying

•     Also used off-label: to help pass kidney/ureteral stones, PTSD-associated nightmares, pre-operative management of phaeochromocytoma

Hypertension — Adults

•     Start at 1 mg once daily (morning or evening). Double the dose at 1–2 week intervals based on response.

•     Usual maintenance: 1–4 mg daily. Maximum: 16 mg daily

Benign Prostatic Hyperplasia — Adults

•     Start at 1 mg once daily. Increase to 2 mg, 4 mg, then up to 8 mg at 1–2 week intervals

•     Maximum: 8 mg daily

Elderly

•     Start at 0.5–1 mg. Titrate very gradually — elderly patients are more prone to first-dose hypotension and falls

Take once daily at the same time each day, with or without food. If therapy is interrupted for several days, restart at 1 mg and re-titrate slowly.

Missed Dose

Take as soon as you remember, unless it is almost time for the next dose — skip the missed dose and continue normally. Never double up.

Common (may affect more than 1 in 10 patients)

•     Dizziness and lightheadedness — especially after the first dose or any dose increase

•     Orthostatic hypotension: blood pressure drops suddenly when standing — risk of fainting

•     Fatigue and somnolence (drowsiness)

•     Headache

•     Peripheral oedema (swelling in legs and ankles)

•     Palpitations and nausea

Serious — Tell Your Doctor Immediately

•     Syncope (fainting): most likely after first dose or dose increase

•     Intraoperative floppy iris syndrome (IFIS): can complicate cataract surgery — inform your eye surgeon BEFORE any eye operation

•     Priapism (prolonged painful erection): extremely rare but requires immediate medical attention

•     Signs of increased heart failure symptoms (use with caution in heart failure patients)

•     Known hypersensitivity to doxazosin, other quinazolines (prazosin, terazosin), or any ingredient

•     History of orthostatic hypotension

•     Combination with PDE-5 inhibitors for erectile dysfunction (sildenafil, tadalafil, vardenafil) — risk of severe hypotension; sildenafil >25 mg is contraindicated

•     Severe hepatic impairment

•     Congestive heart failure caused by mechanical obstruction (e.g. aortic stenosis, pulmonary embolism)

Pregnancy

Limited data available. Use only when clearly necessary. Untreated hypertension in pregnancy is dangerous.

Breastfeeding

Not recommended — it is unknown whether doxazosin passes into breast milk.

Driving and Machinery

Doxazosin may cause dizziness, drowsiness, and low blood pressure. Do not drive or operate machinery until you know how this medicine affects you — particularly for the first few days of treatment.

Elderly Patients

Higher risk of dizziness and falls. Start with 0.5–1 mg and titrate very slowly. Monitor closely for postural hypotension.

Prostate Cancer

Doxazosin does not treat prostate cancer. Prostate-specific antigen (PSA) testing may be needed to exclude cancer before starting BPH therapy.

•     PDE-5 inhibitors (sildenafil, tadalafil, vardenafil): Significant additive blood pressure lowering — risk of dangerous hypotension. CONTRAINDICATED with vardenafil. Use sildenafil >25 mg with extreme caution (separate by 4 hours)

•     Other antihypertensives and diuretics: Enhanced blood pressure lowering

•     Beta-blockers: Enhanced hypotensive effect and increased risk of first-dose syncope

•     NSAIDs (ibuprofen): May reduce antihypertensive effect of doxazosin

•     CYP3A4 inhibitors (clarithromycin, ritonavir, itraconazole): May increase doxazosin blood levels

•     Alcohol: Enhances hypotensive and sedative effects — avoid, especially on first dose

•     Store at 25°C (15–30°C acceptable), away from light and moisture

POM — Prescription Only Medicine.

•     Always take your first dose at bedtime to minimise the risk of dizziness or fainting

•     Rise slowly from a lying or sitting position — hold on to something stable for support

•     Avoid alcohol, especially in the first week of treatment

•     Tell your eye surgeon that you take or have ever taken doxazosin before any eye operation (including cataract surgery) — this is critical for surgical safety

•     Alpha-1 selectivity: Doxazosin selects alpha-1A (prostate) and alpha-1B (blood vessels) — equal benefit for both indications from a single dose

•     ALLHAT trial data: Doxazosin increased rates of congestive heart failure compared to chlorthalidone as first-line antihypertensive — not recommended as first-line monotherapy for hypertension; preferred only if both hypertension and BPH co-exist

•     IFIS alert: Important for ophthalmology teams — any patient taking or who has ever taken alpha-blockers requires modified cataract surgical technique (small pupil protocol)

•     Beers Criteria: Avoid for hypertension in elderly patients due to excessive hypotension risk and falls — safer alternatives exist (ACE inhibitors, calcium channel blockers)

•     PDE-5 inhibitor co-prescription: Screen medication list at every dispensing — this combination is a common cause of emergency admissions for severe hypotension

Q: Will Cardura shrink my enlarged prostate?

A: No. Cardura relaxes the muscles around the prostate and bladder neck, making urination easier and reducing symptoms, but it does not reduce the actual size of the prostate. For prostate size reduction, other medications such as finasteride or dutasteride (5-alpha reductase inhibitors) are used — your doctor may combine these with Cardura.

Q: How long before I notice improvement?

A: Blood pressure reduction may be seen within 1–2 weeks of regular dosing. Improvement in urinary flow and BPH symptoms typically takes 2 weeks of regular treatment. Some patients may notice changes earlier.

Q: Why did my doctor tell me to take the first tablet at bedtime?

A: The first dose of doxazosin (or after any dose increase) can sometimes cause a significant drop in blood pressure, particularly when you stand up. Taking it at bedtime means any dizziness happens while you are lying down and asleep, greatly reducing the risk of a fall or fainting.