Names and pronunciation
(pray′zoe-sin) Minipress
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Drug reference
(pray′zoe-sin) Minipress
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Func. class.: Antihypertensive
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Chem. class.: α1-Adrenergic blocker, peripheral
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Do not confuse: prazosin/predniSONE
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ACTION: Blocks α-mediated vasocon striction of adrenergic receptors, thereby inducing peripheral vasodilation
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USES: Hypertension, benign prostatic hypertrophy to decrease urine outflow obstruction
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Unlabeled uses: hypertensive urgency, Raynaud’s phenomenon, posttraumatic stress disorder (PTSD), BPH
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CONTRAINDICATIONS: Hyper- sensitivity to this product or other quin- azoline products, history of tamsulosin- induced angioedema Precautions: Pregnancy, breastfeeding, children, geriatric patients, prostate cancer, ocular surgery, orthostatic hypotension, angina, priapism, syncope
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SIDE EFFECTS CNS: Dizziness, headache, drowsiness, anxiety, depression, vertigo, weakness, fatigue, syncope CV: Palpitations, orthostatic hypoten sion, tachycardia, edema, rebound hypertension EENT: Blurred vision, epistaxis, tinnitus, dry mouth, red sclera GI: Nausea, vomiting, diarrhea, constipa- tion, abdominal pain, pancreatitis GU: Urinary frequency, incontinence, impotence, priapism; water, sodium retention
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INTERACTIONS effects—β- Increase: hypotensive blockers, nitroglycerin, alcohol, phos- phodiesterase inhibitors (vardenafil, tadalafil, sildenafil); diuretics, other anti- hypertensives, MAOIs Decrease: antihypertensive effect—NSAIDs Increase: antihypertensive effect— hawthorn Drug/Lab Test Increase: urinary norepinephrine, VMA, BUN, uric acid, LFTs Positive: ANA titer
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TREATMENT OF OVERDOSE: Administer volume expanders or vasopressors, discontinue product, place patient in supine position
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DOSAGE AND ROUTES Hypertension • Adult: PO 1 mg bid or tid increasing to 20 mg/day in divided doses, if required; usual range 6-15 mg/day, max 40 mg/day • Child (unlabeled): PO 5 mcg/kg q6hr; may increase slowly to 25 mcg/kg q 6 hr; max 500 mcg/kg/day or 15 mg/day Benign prostatic hyperplasia (unlabeled) • Adult: PO 2 mg bid Posttraumatic stress disorder (unlabeled) • Adult: PO 1 mg at bedtime, then ti- trated to max 15 mg/day
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Available forms: Caps 1, 2, 5 mg
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Administer: • 1st dose at bedtime to avoid fainting • Without regard to meals • Store at room temperature
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Assess: • Hypertension/HF: B/P (sitting, stand- ing) during initial treatment, periodically thereafter; pulse, jugular venous disten- tion, orthostatic hypotension usually oc- curs on first dose • BUN, uric acid if patient receiving long-term therapy • Weight daily, I&O; edema in feet, legs daily • Benign prostatic hypertrophy (unla- beled): urinary patterns, frequency, stream, dribbling; flow before, during, and after therapy • Beers: avoid use as an antihypertensive in older adults; high risk of orthostatic hypotension • Pregnancy/breastfeeding: use only if benefits outweigh fetal risk; cautious use in breastfeeding, excreted in breast milk
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Evaluate: • Therapeutic response: decreased B/P
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • That fainting occasionally occurs after 1st dose; to take 1st dose at bedtime; not to drive or operate machinery for 4 hr after 1st dose; that full effect may take 4-6 wk • To change positions slowly to prevent orthostatic hypotension • To avoid OTC medications, alcohol un- less approved by prescriber; not to crush, chew caps • Not to discontinue abruptly
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PHARMACOKINETICS Onset 2 hr, peak 2-4 hr, duration 6-12 hr, half-life 2-4 hr; metabolized in liver, excreted via bile, feces (>90%), urine (<10%); protein binding 97%
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• Adult: PO 1 mg bid or tid increasing to 20 mg/day in divided doses, if required; usual range 6-15 mg/day, max 40 mg/day
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• Child (unlabeled): PO 5 mcg/kg q6hr; may increase slowly to 25 mcg/kg q 6 hr; max 500 mcg/kg/day or 15 mg/day Benign prostatic hyperplasia (unlabeled)
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• Adult: PO 2 mg bid Posttraumatic stress disorder (unlabeled)
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• Adult: PO 1 mg at bedtime, then ti- trated to max 15 mg/day
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