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9Lepor HJones KWilliford WThe mechanism of adverse events associated with terazosinAn analysis of the Veterans Affairs cooperative studyJ Urol 16320001134-7.

The dose may be slowly increased to achieve the desired blood pressure responseThe usual recommended dose range is 1 mg to 5 mg administered once a dayhoweversome patients may benefit from doses as high as 20 mg per dayDoses over 20 mg do not appear to provide further blood pressure effect and doses over 40 mg have not been studiedBlood pressure should be monitored at the end of the dosing interval to be sure control is maintained throughout the intervalIt may also be helpful to measure blood pressure 2-3 hours after dosing to see if the maximum and minimum responses are similarand to evaluate symptoms such as dizziness or palpitations which can result from excessive hypotensive responseIf response is substantially diminished at 24 hours an increased dose or use of a twice daily regimen can be consideredIf terazosin administration is discontinued for several days or longertherapy should be reinstituted using the initial dosing regimenIn clinical trialsexcept for the initial dosethe dose was given in the morning.

Studies suggest that alpha-1-adrenoreceptor antagonism is useful in improving the urodynamics in patients with chronic bladder obstruction such as in benign prostatic hyperplasiaBPH

The effect of Hytrin on fertility was assessed in a standard fertility/reproductive performance study in which male and female rats were administered oral doses of 830 and 120 mg/kg/dayFour of 20 male rats given 30 mg/kg240 mg/M 220 times the maximum recommended human doseand five of 19 male rats given 120 mg/kg960 mg/M 280 times the maximum recommended human dosefailed to sire a litterTesticular weights and morphology were unaffected by treatmentVaginal smears at 30 and 120 mg/kg/dayhoweverappeared to contain less sperm than smears from control matings and good correlation was reported between sperm count and subsequent pregnancy.

If administration is discontinued for more than several daystherapy should be re-instituted using the initial dosing regimen.

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