Prazosin Side Effects
Some side effects of prazosin may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.
For the Consumer
Applies to prazosin: oral capsule, oral tablet
Along with its needed effects, prazosin may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking prazosin:More common
- Dizziness or lightheadedness, especially when getting up from a lying or sitting position
- fainting (sudden)
- Loss of bladder control
- pounding heartbeat
- swelling of the feet or lower legs
- Chest pain
- painful inappropriate erection of penis (continuing)
- shortness of breath
Some side effects of prazosin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:More common
- lack of energy
- Dryness of the mouth
- unusual tiredness or weakness
- Frequent urge to urinate
For Healthcare Professionals
Applies to prazosin: compounding powder, oral capsule
Although all patients are susceptible to prazosin-induced postural hypotension, risk factors include higher doses, coadministration of beta-blockers, and preexisting serum sodium depletion.
Animal studies have revealed that prazosin exerts a negative chronotropic action on the sinus node of the dog. Rare evidence of associated bradycardia in man has been reported. A 50-year-old man with benign prostatic hypertrophy developed presyncope, described as "lightheadedness within 45 minutes after taking prazosin". The patient was referred for pacemaker placement. The patient was convinced that the drug was the offending agent, so he stopped it and became asymptomatic. A follow-up electrocardiogram revealed normal sinus rhythm at 55 beats per minute, and the pacemaker placement was cancelled. The author of this case report has located two other such cases that were reported to the United Kingdom Committee on Safety of Medicines over a 30-year period.
Cardiovascular side effects are common during initial therapy. A postural hypotension "first dose effect" has occurred in up to 10% to 70% of patients. For this reason, it is recommended that therapy be started with the patient supine, preferably at bedtime. Syncope has been reported in approximately 1% of patients. Other side effects have included palpitations in 7% to 14% of patients, fluid retention in 5% of patients, and rare case reports of angina and sinus bradycardia. Palpitations may have been due to reflex tachycardia secondary to prazosin-induced decreased peripheral vascular resistance and systemic blood pressure.
Ocular side effects including Intraoperative Floppy Iris Syndrome (IFIS) have been observed in some patients undergoing phacoemulsification cataract surgery while being treated with alpha-1 blockers.
Most reports were in patients treated with an alpha-1 blocker at the time IFIS occurred, but in some instances the alpha-1 blocker had been stopped prior to surgery. The manufacturer recommends that patients be questioned to determine whether or not they have taken alpha-1 blockers prior to being considered for cataract surgery. If it is determined that the patient has taken an alpha-1 blocker, the patient's ophthalmologist should be prepared for possible modifications to their surgical technique that may be necessary should IFIS be observed during the procedure.
Hallucinations, irritability, and confusion have been reported in less than 1% of patients. A rare case of hypothermia has been associated with the use of prazosin.
Nervous system side effects have included headache in 8% to 18% (more common in patients with a history of migraine), fatigue in 8%, and blurred vision in less than 5% of patients.
Genitourinary side effects have often been due to alpha-adrenergic blockade of the urinary sphincter muscle.
Genitourinary side effects have included urinary frequency and incontinence. Impotence has been reported in less than 1% of male patients. Priapism has been reported in a few cases, and may be more likely in patients with renal insufficiency.
Gastrointestinal side effects have included nausea in about 5% of patients. Constipation or diarrhea has occurred in less than 4% of patients. Xerostomia has been less common than with less selective alpha-adrenergic receptor blockers.
Rare cases of fecal incontinence, thought to be due to alpha-adrenergic blockade of the anal sphincter due to prazosin, have been reported.
Hypersensitivity reactions have been rare, and have included urticaria and a serum sickness-like reaction manifest as fever, arthralgias, and cold sweats.
Respiratory side effects have been limited to nasal congestion in less than 4% of patients.
Musculoskeletal side effects including rare cases of musculoskeletal complaints and acute febrile polyarthritis have been associated with the use of prazosin. The suspected mechanism is immunologic hypersensitivity.
More about prazosin
- Other brands: Minipress
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