Terazosin Efficacy and Safety

Treatment of Benign Prostatic Hyperplasia (BPH)

Terazosin is an alpha-1 adrenergic blocker that works by inhibiting alpha-1 adrenergic-mediated contraction of prostatic smooth muscle, relieving bladder outlet obstruction 1, 2
Meta-analyzed data shows terazosin is effective in partially relieving BPH symptoms, producing on average a 4-to-6 point improvement in the AUA Symptom Index 1
In network meta-analyses, terazosin shows an improvement of -3.7 points in IPSS (International Prostate Symptom Score) compared to placebo 3

Efficacy is dose-dependent for terazosin—higher doses generally provide greater observed improvement 1
Clinical data support the efficacy and safety of titrating patients up to 10 mg of terazosin 1, 2

Primary adverse events reported with terazosin therapy include orthostatic hypotension 1, dizziness 2, tiredness (asthenia) 2, ejaculatory problems 1, and nasal congestion 1, 2
Patients with planned cataract surgery should be informed of the risks of intraoperative floppy iris syndrome (IFIS) associated with alpha blockers 3

In men with hypertension and cardiac risk factors, alpha blockers like terazosin should not necessarily be assumed to constitute optimal management of concomitant hypertension 1
The American Urological Association guidelines state that alfuzosin, doxazosin, tamsulosin, and terazosin have equal clinical effectiveness for treating LUTS secondary to BPH 1, 3
Tamsulosin appears to have a lower probability of orthostatic hypotension but a higher probability of ejaculatory dysfunction compared to terazosin and other alpha blockers 1
The choice of alpha blocker should be based on patient age, comorbidities, and different adverse event profiles 3