Prazosin Dosing Guidelines

Standard Dosing Schedule

• The JNC-7 guidelines confirm prazosin requires 2-3 times daily administration for hypertension management 1

Context-Specific Dosing

• For patients with PTSD-related nightmares, bedtime dosing is standard, with mean effective doses ranging from 3.1 mg to 15.6 mg, and some protocols include a mid-morning dose in addition to bedtime administration 2
• The American College of Cardiology recommends prazosin 2-20 mg per day in 2-3 divided doses when used for hypertension with concomitant BPH 3

Special Populations

• Elderly patients are more susceptible to orthostatic hypotension and require careful blood pressure monitoring 3, 4

Discontinuation

• When discontinuing prazosin, abrupt cessation is generally safe as it does not cause withdrawal phenomena, unlike clonidine 4

Prazosin Dosing Guidelines

Context-Specific Maximum Dosing

• The American Academy of Sleep Medicine reports that in large VA studies, prazosin was escalated to a maximum of 20 mg as a single bedtime dose for PTSD-related nightmares 5
• Mean achieved doses in military veterans ranged from 14.8-15.6 mg for men and 7.0 mg for women, all below the 20 mg maximum for PTSD-related nightmares 5