Cardura XL (doxazosin) Disease Interactions

There are 3 disease interactions with Cardura XL (doxazosin):

Alpha-1 Blockers (Includes Cardura XL) ↔ Hypotension

Severe Potential Hazard, High plausibility

Applies to: Syncope, Autonomic Neuropathy, Hypotension, Dehydration, Diarrhea, Vomiting

Peripheral alpha 1-adrenergic receptor blocking agents (aka alpha 1-blockers) cause vasodilation and can produce marked hypotension, especially orthostatic hypotension with syncope or other postural symptoms such as dizziness, lightheadedness, and palpitations. Orthostatic effects are most common during initiation of therapy and often occur within 90 minutes after the first dose. However, they can also occur following a dosage increase or resumption of therapy after an interruption of more than a few days. Agents with alpha 1a specificity, such as tamsulosin, act primarily on the prostate but are not devoid of hypotensive effects. Therapy with peripheral alpha-1 blockers should be administered cautiously in patients with or predisposed to hypotensive or syncopal episodes. Caution is also advised in patients who are dehydrated (e.g., due to severe or prolonged diarrhea or vomiting), since they may be more sensitive to the hypotensive effect of the drugs. Therapy should be initiated with the lowest dosage possible and titrated gradually based on patient response and tolerance in accordance with the individual product package labeling. During initiation or reinstitution of therapy and following an increase in dosage, patients should be advised not to rise abruptly from a sitting or recumbent position and to avoid situations where injury could result if syncope occur. Concomitant use of alcohol, extensive periods of standing, prolonged or intense exercise, and exposure to heat can also precipitate orthostatic hypotension and should be minimized. If dizziness, lightheadedness or palpitations occur, the patient should sit or lie down, and seek medical attention if symptoms are recurrent or bothersome.

References

  1. Graham RM, Thornell IR, Gain JM, Bagnoli C, Oates HF, Stokes GS "Prazosin: the first-dose phenomenon." Br Med J 2 (1976): 1293-4
  2. "Product Information. Cardura (doxazosin)." Pfizer US Pharmaceuticals, New York, NY.
  3. Ahaneku JE, Taylor OG, Walker D, Agbedana OE, Salako LA "Blood pressure and biochemical changes during doxazosin monotherapy in nigerian hypertensive patients." Curr Ther Res Clin Exp 55 (1994): 1067-74
View all 14 references

Doxazosin (Includes Cardura XL) ↔ Liver Disease

Moderate Potential Hazard, High plausibility

Applies to: Liver Disease, Biliary Obstruction

Doxazosin is metabolized by the liver and subsequently excreted in the bile, primarily as metabolites, some of which are pharmacologically active. In patients with cirrhosis (Child-Pugh Class A) given a single 2 mg dose, there was a 40% increase in exposure to doxazosin compared to patients with normal hepatic function. The clearance was reduced by 30%, while elimination half-life was not significantly changed. Therapy with doxazosin should be administered cautiously in patients with significantly impaired hepatic or biliary function, since drug and/or metabolite accumulation may occur.

References

  1. Young RA, Brogden RN "Doxazosin. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in mild or moderate hypertension." Drugs 35 (1988): 525-41
  2. Elliott HL, Meredith PA, Reid JL "Pharmacokinetic overview of doxazosin." Am J Cardiol 59 (1987): g78-81
  3. Penenberg D, Chung M, Walmsley P, Vashi V "The effects of hepatic impairment on the pharmacokinetics of docazosin." J Clin Pharmacol 40 (2000): 67-73
View all 5 references

Doxazosin (Includes Cardura XL) ↔ Neutropenia

Moderate Potential Hazard, Moderate plausibility

Applies to: Neutropenia

Slight but sometimes clinically significant decreases in white blood cell and neutrophil counts have occurred during treatment with some of the peripheral alpha 1-adrenergic receptor blocking agents (aka alpha 1-blockers), including doxazosin. Reported cases were generally asymptomatic and reversible. Patients with preexisting neutropenia or bone marrow depression may require closer monitoring during therapy with alpha 1-blockers.

References

  1. "Product Information. Cardura (doxazosin)." Pfizer US Pharmaceuticals, New York, NY.

You should also know about...

Cardura XL (doxazosin) drug Interactions

There are 415 drug interactions with Cardura XL (doxazosin)

Cardura XL (doxazosin) alcohol/food Interactions

There is 1 alcohol/food interaction with Cardura XL (doxazosin)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

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