Terazosin


Chartwell Rx, Llc
Human Prescription Drug
NDC 62135-461
Terazosin is a human prescription drug labeled by 'Chartwell Rx, Llc'. National Drug Code (NDC) number for Terazosin is 62135-461. This drug is available in dosage form of Capsule. The names of the active, medicinal ingredients in Terazosin drug includes Terazosin Hydrochloride - 10 mg/1 . The currest status of Terazosin drug is Active.

Drug Information:

Drug NDC: 62135-461
The labeler code and product code segments of the National Drug Code number, separated by a hyphen. Asterisks are no longer used or included within the product code segment to indicate certain configurations of the NDC.
Proprietary Name: Terazosin
Also known as the trade name. It is the name of the product chosen by the labeler.
Product Type: Human Prescription Drug
Indicates the type of product, such as Human Prescription Drug or Human OTC Drug. This data element corresponds to the “Document Type” of the SPL submission for the listing.
Non Proprietary Name: Terazosin
Also known as the generic name, this is usually the active ingredient(s) of the product.
Labeler Name: Chartwell Rx, Llc
Name of Company corresponding to the labeler code segment of the ProductNDC.
Dosage Form: Capsule
The translation of the DosageForm Code submitted by the firm. There is no standard, but values may include terms like `tablet` or `solution for injection`.The complete list of codes and translations can be found www.fda.gov/edrls under Structured Product Labeling Resources.
Status: Active
FDA does not review and approve unfinished products. Therefore, all products in this file are considered unapproved.
Substance Name:TERAZOSIN HYDROCHLORIDE - 10 mg/1
This is the active ingredient list. Each ingredient name is the preferred term of the UNII code submitted.
Route Details:ORAL
The translation of the Route Code submitted by the firm, indicating route of administration. The complete list of codes and translations can be found at www.fda.gov/edrls under Structured Product Labeling Resources.

Marketing Information:

An openfda section: An annotation with additional product identifiers, such as NUII and UPC, of the drug product, if available.
Marketing Category: ANDA
Product types are broken down into several potential Marketing Categories, such as New Drug Application (NDA), Abbreviated New Drug Application (ANDA), BLA, OTC Monograph, or Unapproved Drug. One and only one Marketing Category may be chosen for a product, not all marketing categories are available to all product types. Currently, only final marketed product categories are included. The complete list of codes and translations can be found at www.fda.gov/edrls under Structured Product Labeling Resources.
Marketing Start Date: 30 Apr, 2021
This is the date that the labeler indicates was the start of its marketing of the drug product.
Marketing End Date: 28 Dec, 2025
This is the date the product will no longer be available on the market. If a product is no longer being manufactured, in most cases, the FDA recommends firms use the expiration date of the last lot produced as the EndMarketingDate, to reflect the potential for drug product to remain available after manufacturing has ceased. Products that are the subject of ongoing manufacturing will not ordinarily have any EndMarketingDate. Products with a value in the EndMarketingDate will be removed from the NDC Directory when the EndMarketingDate is reached.
Application Number: ANDA075614
This corresponds to the NDA, ANDA, or BLA number reported by the labeler for products which have the corresponding Marketing Category designated. If the designated Marketing Category is OTC Monograph Final or OTC Monograph Not Final, then the Application number will be the CFR citation corresponding to the appropriate Monograph (e.g. “part 341”). For unapproved drugs, this field will be null.
Listing Expiration Date: 31 Dec, 2024
This is the date when the listing record will expire if not updated or certified by the firm.

OpenFDA Information:

An openfda section: An annotation with additional product identifiers, such as NUII and UPC, of the drug product, if available.
Manufacturer Name:Chartwell RX, LLC
Name of manufacturer or company that makes this drug product, corresponding to the labeler code segment of the NDC.
RxCUI:260376
313215
313217
313219
The RxNorm Concept Unique Identifier. RxCUI is a unique number that describes a semantic concept about the drug product, including its ingredients, strength, and dose forms.
Original Packager:Yes
Whether or not the drug has been repackaged for distribution.
UPC:0362135461904
0362135460907
0362135459901
0362135458904
UPC stands for Universal Product Code.
UNII:D32S14F082
Unique Ingredient Identifier, which is a non-proprietary, free, unique, unambiguous, non-semantic, alphanumeric identifier based on a substance’s molecular structure and/or descriptive information.
Pharmacologic Class:Adrenergic alpha-Antagonists [MoA]
alpha-Adrenergic Blocker [EPC]
These are the reported pharmacological class categories corresponding to the SubstanceNames listed above.

Packaging Information:

Package NDCDescriptionMarketing Start DateMarketing End DateSample Available
62135-461-9090 CAPSULE in 1 BOTTLE (62135-461-90)01 Feb, 2023N/ANo
Package NDC number, known as the NDC, identifies the labeler, product, and trade package size. The first segment, the labeler code, is assigned by the FDA. Description tells the size and type of packaging in sentence form. Multilevel packages will have the descriptions concatenated together.

Product Elements:

Terazosin terazosin lactose monohydrate starch, corn crospovidone talc magnesium stearate titanium dioxide gelatin shellac ferrosoferric oxide propylene glycol fd&c blue no. 2--aluminum lake fd&c red no. 40 d&c yellow no. 10 aluminum lake fd&c blue no. 1 aluminum lake terazosin hydrochloride terazosin opaque cap and body 735;1mg terazosin terazosin lactose monohydrate starch, corn crospovidone talc magnesium stearate titanium dioxide d&c yellow no. 10 gelatin d&c red no. 33 shellac ferrosoferric oxide propylene glycol fd&c blue no. 2--aluminum lake fd&c red no. 40 d&c yellow no. 10 aluminum lake fd&c blue no. 1 aluminum lake terazosin hydrochloride terazosin (opaque cap) , white (opaque body) 736;2mg terazosin terazosin lactose monohydrate starch, corn crospovidone talc magnesium stearate titanium dioxide fd&c blue no. 1 fd&c red no. 40 gelatin shellac ferrosoferric oxide propylene glycol fd&c blue no. 2--aluminum lake d&c yellow no. 10 aluminum lake fd&c blue no. 1 aluminum lake terazosin hydrochloride terazosin (opaque cap) , white (opaque body) 737;5mg terazosin terazosin lactose monohydrate starch, corn crospovidone talc magnesium stearate titanium dioxide fd&c blue no. 1 gelatin shellac ferrosoferric oxide propylene glycol fd&c blue no. 2--aluminum lake fd&c red no. 40 d&c yellow no. 10 aluminum lake fd&c blue no. 1 aluminum lake terazosin hydrochloride terazosin (aqua opaque cap) , white (opaque body) 738;10mg

Drug Interactions:

Drug interactions in controlled trials, terazosin has been added to diuretics, and several beta-adrenergic blockers; no unexpected interactions were observed. terazosin has also been used in patients on a variety of concomitant therapies; while these were not formal interaction studies, no interactions were observed. terazosin has been used concomitantly in at least 50 patients on the following drugs or drug classes: 1) analgesic/anti-inflammatory (e.g., acetaminophen, aspirin, codeine, ibuprofen, indomethacin); 2) antibiotics (e.g., erythromycin, trimethoprim and sulfamethoxazole); 3) anticholinergic/sympathomimetics (e.g., phenylephrine hydrochloride, phenylpropanolamine hydrochloride, pseudoephedrine hydrochloride); 4) antigout (e.g., allopurinol); 5) antihistamines (e.g., chlorpheniramine); 6) cardiovascular agents (e.g., atenolol, hydrochlorothiazide, methyclothiazide, propranolol); 7) corticosteroids; 8) gastrointestinal agents (e.g., antacids); 9) hypoglycemics; 10) sedatives an
d tranquilizers (e.g., diazepam). use with other drugs in a study (n = 24) where terazosin and verapamil were administered concomitantly, terazosin's mean auc 0 to 24 increased 11% after the first verapamil dose and after 3 weeks of verapamil treatment it increased by 24% with associated increases in c max (25%) and c min (32%) means. terazosin mean t max decreased from 1.3 hours to 0.8 hours after 3 weeks of verapamil treatment. statistically significant differences were not found in the verapamil level with and without terazosin. in a study (n = 6) where terazosin and captopril were administered concomitantly, plasma disposition of captopril was not influenced by concomitant administration of terazosin and terazosin maximum plasma concentrations increased linearly with dose at steady-state after administration of terazosin plus captopril (see dosage and administration ). carcinogenesis, mutagenesis, impairment of fertility terazosin was devoid of mutagenic potential when evaluated in vivo and in vitro (the ames test, in vivo cytogenetics, the dominant lethal test in mice, in vivo chinese hamster chromosome aberration test and v79 forward mutation assay). terazosin, administered in the feed to rats at doses of 8, 40, and 250 mg/kg/day (70, 350, and 2100 mg/m2/day), for two years, was associated with a statistically significant increase in benign adrenal medullary tumors of male rats exposed to the 250 mg/kg dose. this dose is 175 times the maximum recommended human dose of 20 mg (12 mg/m2). female rats were unaffected. terazosin was not oncogenic in mice when administered in feed for 2 years at a maximum tolerated dose of 32 mg/kg/day (110 mg/m2; 9 times the maximum recommended human dose). the absence of mutagenicity in a battery of tests, of tumorigenicity of any cell type in the mouse carcinogenicity assay, of increased total tumor incidence in either species, and of proliferative adrenal lesions in female rats, suggests a male rat species-specific event. numerous other diverse pharmaceutical and chemical compounds have also been associated with benign adrenal medullary tumors in male rats without supporting evidence for carcinogenicity in man. the effect of terazosin on fertility was assessed in a standard fertility/reproductive performance study in which male and female rats were administered oral doses of 8, 30 and 120 mg/kg/day. four of 20 male rats given 30 mg/kg (240 mg/m2; 20 times the maximum recommended human dose) and five of 19 male rats given 120 mg/kg (960 mg/m2; 80 times the maximum recommended human dose) failed to sire a litter. testicular weights and morphology were unaffected by treatment. vaginal smears at 30 and 120 mg/kg/day, however, appeared to contain less sperm than smears from control matings and good correlation was reported between sperm count and subsequent pregnancy. oral administration of terazosin for one or two years elicited a statistically significant increase in the incidence of testicular atrophy in rats exposed to 40 and 250 mg/kg/day (29 and 175 times the maximum recommended human dose), but not in rats exposed to 8 mg/kg/day (> 6 times the maximum recommended human dose). testicular atrophy was also observed in dogs dosed with 300 mg/kg/day (> 500 times the maximum recommended human dose) for three months but not after one year when dosed with 20 mg/kg/day (38 times the maximum recommended human dose). this lesion has also been seen with prazosin hydrochloride, another (marketed) selective-alpha-1 blocking agent.

Indications and Usage:

Indications and usage terazosin capsules are indicated for the treatment of symptomatic benign prostatic hyperplasia (bph). there is a rapid response, with approximately 70% of patients experiencing an increase in urinary flow and improvement in symptoms of bph when treated with terazosin. the long term effects of terazosin on the incidence of surgery, acute urinary obstruction or other complications of bph are yet to be determined. terazosin capsules are also indicated for the treatment of hypertension. they can be used alone or in combination with other antihypertensive agents such as diuretics or beta-adrenergic blocking agents.

Warnings:

Warnings syncope and "first-dose" effect terazosin capsules, like other alpha-adrenergic blocking agents, can cause marked lowering of blood pressure, especially postural hypotension, and syncope in association with the first dose or first few days of therapy. a similar effect can be anticipated if therapy is interrupted for several days and then restarted. syncope has also been reported with other alpha-adrenergic blocking agents in association with rapid dosage increases or the introduction of another antihypertensive drug. syncope is believed to be due to an excessive postural hypotensive effect, although occasionally the syncopal episode has been preceded by a bout of severe supraventricular tachycardia with heart rates of 120 to 160 beats per minute. additionally, the possibility of the contribution of hemodilution to the symptoms of postural hypotension should be considered. to decrease the likelihood of syncope or excessive hypotension, treatment should always be initiated with
a 1 mg dose of terazosin, given at bedtime. the 2 mg, 5 mg and 10 mg capsules are not indicated as initial therapy. dosage should then be increased slowly, according to recommendations in the dosage and administration section and additional antihypertensive agents should be added with caution. the patient should be cautioned to avoid situations, such as driving or hazardous tasks, where injury could result should syncope occur during initiation of therapy. in early investigational studies, where increasing single doses up to 7.5 mg were given at 3 day intervals, tolerance to the first dose phenomenon did not necessarily develop and the "first dose" effect could be observed at all doses. syncopal episodes occurred in 3 of the 14 subjects given terazosin at doses of 2.5, 5 and 7.5 mg, which are higher than the recommended initial dose; in addition, severe orthostatic hypotension (blood pressure falling to 50/0 mmhg) was seen in two others and dizziness, tachycardia, and lightheadedness occurred in most subjects. these adverse effects all occurred within 90 minutes of dosing. in three placebo-controlled bph studies 1, 2, and 3 (see clinical pharmacology ), the incidence of postural hypotension in the terazosin treated patients was 5.1%, 5.2%, and 3.7% respectively. in multiple dose clinical trials involving nearly 2000 hypertensive patients treated with terazosin, syncope was reported in about 1% of patients. syncope was not necessarily associated only with the first dose. if syncope occurs, the patient should be placed in a recumbent position and treated supportively as necessary. there is evidence that the orthostatic effect of terazosin is greater, even in chronic use, shortly after dosing. the risk of the events is greatest during the initial seven days of treatment, but continues at all time intervals. priapism rarely, (probably less than once in every several thousand patients), terazosin and other α1 – antagonists have been associated with priapism (painful penile erection, sustained for hours and unrelieved by sexual intercourse or masturbation). two or three dozen cases have been reported. because this condition can lead to permanent impotence if not promptly treated, patients must be advised about the seriousness of the condition (see precautions , information for patients ).

Dosage and Administration:

Dosage and administration if terazosin capsules administration is discontinued for several days, therapy should be reinstituted using the initial dosing regimen. benign prostatic hyperplasia initial dose 1 mg at bedtime is the starting dose for all patients, and this dose should not be exceeded as an initial dose. patients should be closely followed during initial administration in order to minimize the risk of severe hypotensive response. subsequent doses the dose should be increased in a stepwise fashion to 2 mg, 5 mg, or 10 mg once daily to achieve the desired improvement of symptoms and/or flow rates. doses of 10 mg once daily are generally required for the clinical response. therefore, treatment with 10 mg for a minimum of 4 to 6 weeks may be required to assess whether a beneficial response has been achieved. some patients may not achieve a clinical response despite appropriate titration. although some additional patients responded at a 20 mg daily dose, there was an insufficient
number of patients studied to draw definitive conclusions about this dose. there are insufficient data to support the use of higher doses for those patients who show inadequate or no response to 20 mg daily. if terazosin administration is discontinued for several days or longer, therapy should be reinstituted using the initial dosing regimen. use with other drugs caution should be observed when terazosin capsules are administered concomitantly with other antihypertensive agents, especially the calcium channel blocker verapamil, to avoid the possibility of developing significant hypotension. when using terazosin and other antihypertensive agents concomitantly, dosage reduction and retitration of either agent may be necessary (see precautions ). hypotension has been reported when terazosin capsules have been used with phosphodiesterase-5 (pde-5) inhibitors. hypertension the dose of terazosin capsules and the dose interval (12 or 24 hours) should be adjusted according to the patient's individual blood pressure response. the following is a guide to its administration: initial dose 1 mg at bedtime is the starting dose for all patients, and this dose should not be exceeded. this initial dosing regimen should be strictly observed to minimize the potential for severe hypotensive effects. subsequent doses the dose may be slowly increased to achieve the desired blood pressure response. the usual recommended dose range is 1 mg to 5 mg administered once a day; however, some patients may benefit from doses as high as 20 mg per day. doses over 20 mg do not appear to provide further blood pressure effect and doses over 40 mg have not been studied. blood pressure should be monitored at the end of the dosing interval to be sure control is maintained throughout the interval. it may also be helpful to measure blood pressure 2 to 3 hours after dosing to see if the maximum and minimum responses are similar, and to evaluate symptoms such as dizziness or palpitations which can result from excessive hypotensive response. if response is substantially diminished at 24 hours an increased dose or use of a twice daily regimen can be considered. if terazosin administration is discontinued for several days or longer, therapy should be reinstituted using the initial dosing regimen. in clinical trials, except for the initial dose, the dose was given in the morning. use with other drugs (see above).

Contraindications:

Contraindications terazosin capsules are contraindicated in patients known to be hypersensitive to terazosin hydrochloride.

Adverse Reactions:

Adverse reactions benign prostatic hyperplasia the incidence of treatment-emergent adverse events has been ascertained from clinical trials conducted worldwide. all adverse events reported during these trials were recorded as adverse reactions. the incidence rates presented below are based on combined data from six placebo-controlled trials involving once-a-day administration of terazosin at doses ranging from 1 to 20 mg. table 1 summarizes those adverse events reported for patients in these trials when the incidence rate in the terazosin group was at least 1% and was greater than that for the placebo group, or where the reaction is of clinical interest. asthenia, postural hypotension, dizziness, somnolence, nasal congestion/rhinitis, and impotence were the only events that were significantly (p ≤ 0.05) more common in patients receiving terazosin than in patients receiving placebo. the incidence of urinary tract infection was significantly lower in the patients receiving terazosin
than in patients receiving placebo. an analysis of the incidence rate of hypotensive adverse events (see precautions ) adjusted for the length of drug treatment has shown that the risk of the events is greatest during the initial seven days of treatment, but continues at all time intervals. table 1 adverse reactions during placebo-controlled trials benign prostatic hyperplasia body system terazosin (n = 636) placebo (n = 360) body as a whole † asthenia 7.4% * 3.3% flu syndrome 2.4% 1.7% headache 4.9% 5.8% cardiovascular system hypotension 0.6% 0.6% palpitations 0.9% 1.1% postural hypotension 3.9% * 0.8% syncope 0.6% 0.0% digestive system nausea 1.7% 1.1% metabolic and nutritional disorders peripheral edema 0.9% 0.3% weight gain 0.5% 0.0% nervous system dizziness 9.1% * 4.2% somnolence 3.6% * 1.9% vertigo 1.4% 0.3% respiratory system dyspnea 1.7% 0.8% nasal congestion/rhinitis 1.9% * 0.0% special senses blurred vision/amblyopia 1.3% 0.6% urogenital system impotence 1.6% * 0.6% urinary tract infection 1.3% 3.9% * * includes weakness, tiredness, lassitude, and fatigue. † p ≤ 0.05 comparison between groups. additional adverse events have been reported, but these are, in general, not distinguishable from symptoms that might have occurred in the absence of exposure to terazosin. the safety profile of patients treated in the long-term open-label study was similar to that observed in the controlled studies. the adverse events were usually transient and mild or moderate in intensity, but sometimes were serious enough to interrupt treatment. in the placebo-controlled clinical trials, the rates of premature termination due to adverse events were not statistically different between the placebo and terazosin groups. the adverse events that were bothersome, as judged by their being reported as reasons for discontinuation of therapy by at least 0.5% of the terazosin group and being reported more often than in the placebo group, are shown in table 2. table 2 discontinuation during placebo-controlled trials benign prostatic hyperplasia body system terazosin (n = 636) placebo (n = 360) body as a whole fever 0.5% 0.0% headache 1.1% 0.8% cardiovascular system postural hypotension 0.5% 0.0% syncope 0.5% 0.0% digestive system nausea 0.5% 0.3% nervous system dizziness 2.0% 1.1% vertigo 0.5% 0.0% respiratory system dyspnea 0.5% 0.3% special senses blurred vision/amblyopia 0.6% 0.0% urogenital system urinary tract infection 0.5% 0.3% hypertension the prevalence of adverse reactions has been ascertained from clinical trials conducted primarily in the united states. all adverse experiences (events) reported during these trials were recorded as adverse reactions. the prevalence rates presented below are based on combined data from fourteen placebo-controlled trials involving once-a-day administration of terazosin, as monotherapy or in combination with other antihypertensive agents, at doses ranging from 1 to 40 mg. table 3 summarizes those adverse experiences reported for patients in these trials where the prevalence rate in the terazosin group was at least 5%, where the prevalence rate for the terazosin group was at least 2% and was greater than the prevalence rate for the placebo group, or where the reaction is of particular interest. asthenia, blurred vision, dizziness, nasal congestion, nausea, peripheral edema, palpitations and somnolence were the only symptoms that were significantly (p < 0.05) more common in patients receiving terazosin than in patients receiving placebo. similar adverse reaction rates were observed in placebo-controlled monotherapy trials. table 3 adverse reactions during placebo-controlled trials hypertension body system terazosin (n = 636) placebo (n = 360) body as a whole † asthenia 11.3% * 4.3% back pain 2.4% 1.2% headache 16.2% 15.8% cardiovascular system palpitations 4.3% * 1.2% postural hypotension 1.3% 0.4% tachycardia 1.9% 1.2% digestive system nausea 4.4% * 1.4% metabolic and nutritional disorders edema 0.9% 0.6% peripheral edema 5.5% * 2.4% weight gain 0.5% 0.2% musculoskeletal system pain – extremities 3.5% 3.0% nervous system depression 0.3% 0.2% dizziness 19.3% * 7.5% libido decreased 0.6% 0.2% nervousness 2.3% 1.8% paresthesia 2.9% 1.4% somnolence 5.4% * 2.6% respiratory system dyspnea 3.1% 2.4% nasal congestion 5.9% * 3.4% sinusitis 2.6% 1.4% special senses blurred vision 1.6% * 0.0% urogenital system impotence 1.2% 1.4% * includes weakness, tiredness, lassitude, and fatigue. † statistically significant at p=0.05 level. additional adverse reactions have been reported, but these are, in general, not distinguishable from symptoms that might have occurred in the absence of exposure to terazosin. the following additional adverse reactions were reported by at least 1% of 1987 patients who received terazosin in controlled or open, short- or long-term clinical trials or have been reported during marketing experience: body as a whole chest pain, facial edema, fever, abdominal pain, neck pain, shoulder pain cardiovascular system arrhythmia, vasodilation digestive system constipation, diarrhea, dry mouth, dyspepsia, flatulence, vomiting metabolic/nutritional disorders gout musculoskeletal system arthralgia, arthritis, joint disorder, myalgia nervous system anxiety, insomnia respiratory system bronchitis, cold symptoms, epistaxis, flu symptoms, increased cough, pharyngitis, rhinitis skin and appendages pruritus, rash, sweating special senses abnormal vision, conjunctivitis, tinnitus urogenital system urinary frequency, urinary incontinence primarily reported in postmenopausal women, urinary tract infection. the adverse reactions were usually mild or moderate in intensity but sometimes were serious enough to interrupt treatment. the adverse reactions that were most bothersome, as judged by their being reported as reasons for discontinuation of therapy by at least 0.5% of the terazosin group and being reported more often than in the placebo group, are shown in table 4. post-marketing experience post-marketing experience indicates that in rare instances patients may develop allergic reactions, including anaphylaxis, following administration of terazosin hydrochloride. there have been reports of priapism and thrombocytopenia during post-marketing surveillance. atrial fibrillation has been reported. during cataract surgery, a variant of small pupil syndrome known as intraoperative floppy iris syndrome (ifis) has been reported in association with alpha-1 blocker therapy (see precautions ). to report suspected adverse reactions, contact chartwell rx, llc. at 1-845-232-1683 or fda at 1-800-fda-1088 or www.fda.gov/medwatch.

Adverse Reactions Table:

BODY SYSTEMTERAZOSIN(N = 636)PLACEBO(N = 360)
BODY AS A WHOLE
Asthenia 7.4% *3.3%
Flu Syndrome2.4%1.7%
Headache4.9%5.8%
CARDIOVASCULAR SYSTEM
Hypotension0.6%0.6%
Palpitations0.9%1.1%
Postural Hypotension 3.9% *0.8%
Syncope0.6%0.0%
DIGESTIVE SYSTEM
Nausea1.7%1.1%
METABOLIC AND NUTRITIONAL DISORDERS
Peripheral Edema0.9%0.3%
Weight Gain0.5%0.0%
NERVOUS SYSTEM
Dizziness 9.1% *4.2%
Somnolence 3.6% *1.9%
Vertigo1.4%0.3%
RESPIRATORY SYSTEM
Dyspnea1.7%0.8%
Nasal Congestion/Rhinitis 1.9% *0.0%
SPECIAL SENSES
Blurred Vision/Amblyopia1.3%0.6%
UROGENITAL SYSTEM
Impotence 1.6% *0.6%
Urinary Tract Infection1.3%3.9% *

BODY SYSTEMTERAZOSIN (N = 636) PLACEBO (N = 360)
BODY AS A WHOLE
Fever 0.5%0.0%
Headache1.1%0.8%
CARDIOVASCULAR SYSTEM
Postural Hypotension0.5%0.0%
Syncope0.5%0.0%
DIGESTIVE SYSTEM
Nausea0.5%0.3%
NERVOUS SYSTEM
Dizziness2.0%1.1%
Vertigo0.5%0.0%
RESPIRATORY SYSTEM
Dyspnea0.5%0.3%
SPECIAL SENSES
Blurred Vision/Amblyopia0.6%0.0%
UROGENITAL SYSTEM
Urinary Tract Infection0.5%0.3%

BODY SYSTEMTERAZOSIN (N = 636)PLACEBO (N = 360)
BODY AS A WHOLE
Asthenia 11.3% *4.3%
Back Pain2.4%1.2%
Headache16.2%15.8%
CARDIOVASCULAR SYSTEM
Palpitations 4.3% *1.2%
Postural Hypotension1.3%0.4%
Tachycardia1.9%1.2%
DIGESTIVE SYSTEM
Nausea4.4% *1.4%
METABOLIC AND NUTRITIONAL DISORDERS
Edema0.9%0.6%
Peripheral Edema 5.5% *2.4%
Weight Gain0.5%0.2%
MUSCULOSKELETAL SYSTEM
Pain – Extremities3.5%3.0%
NERVOUS SYSTEM
Depression0.3%0.2%
Dizziness 19.3% *7.5%
Libido Decreased0.6%0.2%
Nervousness2.3%1.8%
Paresthesia2.9%1.4%
Somnolence 5.4% *2.6%
RESPIRATORY SYSTEM
Dyspnea3.1%2.4%
Nasal Congestion 5.9% *3.4%
Sinusitis2.6%1.4%
SPECIAL SENSES
Blurred Vision1.6% *0.0%
UROGENITAL SYSTEM
Impotence1.2%1.4%

Drug Interactions:

Drug interactions in controlled trials, terazosin has been added to diuretics, and several beta-adrenergic blockers; no unexpected interactions were observed. terazosin has also been used in patients on a variety of concomitant therapies; while these were not formal interaction studies, no interactions were observed. terazosin has been used concomitantly in at least 50 patients on the following drugs or drug classes: 1) analgesic/anti-inflammatory (e.g., acetaminophen, aspirin, codeine, ibuprofen, indomethacin); 2) antibiotics (e.g., erythromycin, trimethoprim and sulfamethoxazole); 3) anticholinergic/sympathomimetics (e.g., phenylephrine hydrochloride, phenylpropanolamine hydrochloride, pseudoephedrine hydrochloride); 4) antigout (e.g., allopurinol); 5) antihistamines (e.g., chlorpheniramine); 6) cardiovascular agents (e.g., atenolol, hydrochlorothiazide, methyclothiazide, propranolol); 7) corticosteroids; 8) gastrointestinal agents (e.g., antacids); 9) hypoglycemics; 10) sedatives an
d tranquilizers (e.g., diazepam). use with other drugs in a study (n = 24) where terazosin and verapamil were administered concomitantly, terazosin's mean auc 0 to 24 increased 11% after the first verapamil dose and after 3 weeks of verapamil treatment it increased by 24% with associated increases in c max (25%) and c min (32%) means. terazosin mean t max decreased from 1.3 hours to 0.8 hours after 3 weeks of verapamil treatment. statistically significant differences were not found in the verapamil level with and without terazosin. in a study (n = 6) where terazosin and captopril were administered concomitantly, plasma disposition of captopril was not influenced by concomitant administration of terazosin and terazosin maximum plasma concentrations increased linearly with dose at steady-state after administration of terazosin plus captopril (see dosage and administration ). carcinogenesis, mutagenesis, impairment of fertility terazosin was devoid of mutagenic potential when evaluated in vivo and in vitro (the ames test, in vivo cytogenetics, the dominant lethal test in mice, in vivo chinese hamster chromosome aberration test and v79 forward mutation assay). terazosin, administered in the feed to rats at doses of 8, 40, and 250 mg/kg/day (70, 350, and 2100 mg/m2/day), for two years, was associated with a statistically significant increase in benign adrenal medullary tumors of male rats exposed to the 250 mg/kg dose. this dose is 175 times the maximum recommended human dose of 20 mg (12 mg/m2). female rats were unaffected. terazosin was not oncogenic in mice when administered in feed for 2 years at a maximum tolerated dose of 32 mg/kg/day (110 mg/m2; 9 times the maximum recommended human dose). the absence of mutagenicity in a battery of tests, of tumorigenicity of any cell type in the mouse carcinogenicity assay, of increased total tumor incidence in either species, and of proliferative adrenal lesions in female rats, suggests a male rat species-specific event. numerous other diverse pharmaceutical and chemical compounds have also been associated with benign adrenal medullary tumors in male rats without supporting evidence for carcinogenicity in man. the effect of terazosin on fertility was assessed in a standard fertility/reproductive performance study in which male and female rats were administered oral doses of 8, 30 and 120 mg/kg/day. four of 20 male rats given 30 mg/kg (240 mg/m2; 20 times the maximum recommended human dose) and five of 19 male rats given 120 mg/kg (960 mg/m2; 80 times the maximum recommended human dose) failed to sire a litter. testicular weights and morphology were unaffected by treatment. vaginal smears at 30 and 120 mg/kg/day, however, appeared to contain less sperm than smears from control matings and good correlation was reported between sperm count and subsequent pregnancy. oral administration of terazosin for one or two years elicited a statistically significant increase in the incidence of testicular atrophy in rats exposed to 40 and 250 mg/kg/day (29 and 175 times the maximum recommended human dose), but not in rats exposed to 8 mg/kg/day (> 6 times the maximum recommended human dose). testicular atrophy was also observed in dogs dosed with 300 mg/kg/day (> 500 times the maximum recommended human dose) for three months but not after one year when dosed with 20 mg/kg/day (38 times the maximum recommended human dose). this lesion has also been seen with prazosin hydrochloride, another (marketed) selective-alpha-1 blocking agent.

Use in Pregnancy:

Pregnancy teratogenic effects: pregnancy category c terazosin was not teratogenic in either rats or rabbits when administered at oral doses up to 280 and 60 times, respectively, the maximum recommended human dose. fetal resorptions occurred in rats dosed with 480 mg/kg/day, approximately 280 times the maximum recommended human dose. increased fetal resorptions, decreased fetal weight and an increased number of supernumerary ribs were observed in offspring of rabbits dosed with 60 times the maximum recommended human dose. these findings (in both species) were most likely secondary to maternal toxicity. there are no adequate and well-controlled studies in pregnant women and the safety of terazosin in pregnancy has not been established. terazosin is not recommended during pregnancy unless the potential benefit justifies the potential risk to the mother and fetus. nonteratogenic effects in a peri- and post-natal development study in rats, significantly more pups died in the group dosed wit
h 120 mg/kg/day (> 75 times the maximum recommended human dose) than in the control group during the three-week postpartum period. nursing mothers it is not known whether terazosin is excreted in breast milk. because many drugs are excreted in breast milk, caution should be exercised when terazosin is administered to a nursing woman. pediatric use safety and effectiveness in children have not been determined.

Overdosage:

Overdosage should overdosage of terazosin lead to hypotension, support of the cardiovascular system is of first importance. restoration of blood pressure and normalization of heart rate may be accomplished by keeping the patient in the supine position. if this measure is inadequate, shock should first be treated with volume expanders. if necessary, vasopressors should then be used and renal function should be monitored and supported as needed. laboratory data indicate that terazosin is 90 to 94% protein bound; therefore, dialysis may not be of benefit.

Description:

Description terazosin hydrochloride, usp an alpha-1-selective adrenoceptor blocking agent, is a quinazoline derivative. the chemical name for terazosin hydrochloride, usp is (rs)-piperazine, 1-(4-amino-6,7-dimethoxy-2-quinazolinyl)-4-[(tetra-hydro-2-furanyl)carbonyl]-, monohydrochloride, dihydrate. it has the following structural formula: terazosin hydrochloride, usp is a white, crystalline substance, freely soluble in water and isotonic saline. each capsule for oral administration, contains terazosin hydrochloride, usp equivalent to 1 mg, 2 mg, 5 mg or 10 mg terazosin. in addition, each capsule contains the following inactive ingredients: crospovidone, lactose monohydrate, magnesium stearate, talc and corn starch. the capsule shells and imprinting inks contain: titanium dioxide, gelatin, shellac glaze, black iron oxide, n-butyl alcohol, propylene glycol, fd&c blue #2 aluminum lake, fd&c red #40 aluminum lake, d&c yellow #10 aluminum lake and fd&c blue #1. the 2 mg capsule shell also contains d&c red #33. fda approved dissolution test specifications differ from usp. image description

Clinical Pharmacology:

Clinical pharmacology pharmacodynamics a. benign prostatic hyperplasia (bph) the symptoms associated with bph are related to bladder outlet obstruction, which is comprised of two underlying components: a static component and a dynamic component. the static component is a consequence of an increase in prostate size. over time, the prostate will continue to enlarge. however, clinical studies have demonstrated that the size of the prostate does not correlate with the severity of bph symptoms or the degree of urinary obstruction. the dynamic component is a function of an increase in smooth muscle tone in the prostate and bladder neck, leading to constriction of the bladder outlet. smooth muscle tone is mediated by sympathetic nervous stimulation of alpha-1 adrenoceptors, which are abundant in the prostate, prostatic capsule and bladder neck. the reduction in symptoms and improvement in urine flow rates following administration of terazosin is related to relaxation of smooth muscle produced
by blockade of alpha-1 adrenoceptors in the bladder neck and prostate. because there are relatively few alpha-1 adrenoceptors in the bladder body, terazosin is able to reduce the bladder outlet obstruction without affecting bladder contractility. terazosin has been studied in 1222 men with symptomatic bph. in three placebo-controlled studies, symptom evaluation and uroflowmetric measurements were performed approximately 24 hours following dosing. symptoms were quantified using the boyarsky index. the questionnaire evaluated both obstructive (hesitancy, intermittency, terminal dribbling, impairment of size and force of stream, sensation of incomplete bladder emptying) and irritative (nocturia, daytime frequency, urgency, dysuria) symptoms by rating each of the 9 symptoms from 0 to 3, for a total score of 27 points. results from these studies indicated that terazosin statistically significantly improved symptoms and peak urine flow rates over placebo as follows: symptom score (range 0-27) peak flow rate (ml/sec) n mean baseline mean change (%) n mean baseline mean change (%) study 1 (10 mg) a titration to fixed dose (12 wks) placebo terazosin 55 54 9.7 10.1 -2.3 (24) -4.5 (45) * 54 52 10.1 8.8 +1.0 (10) +3.0 (34) * study 2 (2, 5, 10, 20 mg) b titration to response (24 wks) placebo terazosin 89 85 12.5 12.2 -3.8 (30) -5.3 (43) * 88 84 8.8 8.4 +1.4 (16) +2.9 (35) * study 3 (1, 2, 5, 10 mg) c titration to response (24 wks) placebo terazosin 74 73 10.4 10.9 -1.1 (11) -4.6 (42) * 74 73 8.8 8.6 +1.2 (14) +2.6 (30) * a highest dose 10 mg shown. b 23% of patients on 10 mg, 41% of patients on 20 mg. c 67% of patients on 10 mg. * significantly (p ≤ 0.05) more improvement than placebo. in all three studies, both symptom scores and peak urine flow rates showed statistically significant improvement from baseline in patients treated with terazosin from week 2 (or the first clinic visit) and throughout the study duration. analysis of the effect of terazosin on individual urinary symptoms demonstrated that compared to placebo, terazosin significantly improved the symptoms of hesitancy, intermittency, impairment in size and force of urinary stream, sensation of incomplete emptying, terminal dribbling, daytime frequency and nocturia. global assessments of overall urinary function and symptoms were also performed by investigators who were blinded to patient treatment assignment. in studies 1 and 3, patients treated with terazosin had a significantly (p ≤ 0.001) greater overall improvement compared to placebo treated patients. in a short term study (study 1), patients were randomized to either 2, 5 or 10 mg of terazosin or placebo. patients randomized to the 10 mg group achieved a statistically significant response in both symptoms and peak flow rate compared to placebo (figure 1) . in a long-term, open-label, non-placebo controlled clinical trial, 181 men were followed for 2 years and 58 of these men were followed for 30 months. the effect of terazosin on urinary symptom scores and peak flow rates was maintained throughout the study duration (figures 2 and 3) : in this long-term trial, both symptom scores and peak urinary flow rates showed statistically significant improvement suggesting a relaxation of smooth muscle cells. although blockade of alpha-1 adrenoceptors also lowers blood pressure in hypertensive patients with increased peripheral vascular resistance, terazosin treatment of normotensive men with bph did not result in a clinically significant blood pressure lowering effect: mean changes in blood pressure from baseline to final visit in all double-blind, placebo-controlled studies normotensive patients dbp ≤ 90 mmhg hypertensive patients dbp >90 mmhg group n mean change n mean change sbp (mmhg) placebo terazosin 293 519 -0.1 -3.3 * 45 65 -5.8 -14.4 * dbp (mmhg) placebo terazosin 293 519 +0.4 -2.2 * 45 65 -7.1 -15.1 * * p ≤ 0.05 vs. placebo b. hypertension in animals, terazosin causes a decrease in blood pressure by decreasing total peripheral vascular resistance. the vasodilatory hypotensive action of terazosin appears to be produced mainly by blockade of alpha-1-adrenoceptors. terazosin decreases blood pressure gradually within 15 minutes following oral administration. patients in clinical trials of terazosin were administered once daily (the great majority) and twice daily regimens with total doses usually in the range of 5 to 20 mg/day, and had mild (about 77%, diastolic pressure 95 to 105 mmhg) or moderate (23%, diastolic pressure 105 to 115 mmhg) hypertension. because terazosin, like all alpha antagonists, can cause unusually large falls in blood pressure after the first dose or first few doses, the initial dose was 1 mg in virtually all trials, with subsequent titration to a specified fixed dose or titration to some specified blood pressure end point (usually a supine diastolic pressure of 90 mmhg). blood pressure responses were measured at the end of the dosing interval (usually 24 hours) and effects were shown to persist throughout the interval, with the usual supine responses 5 to 10 mmhg systolic and 3.5 to 8 mmhg diastolic greater than placebo. the responses in the standing position tended to be somewhat larger, by 1 to 3 mmhg, although this was not true in all studies. the magnitude of the blood pressure responses was similar to prazosin and less than hydrochlorothiazide (in a single study of hypertensive patients). in measurements 24 hours after dosing, heart rate was unchanged. limited measurements of peak response (2 to 3 hours after dosing) during chronic terazosin administration indicate that it is greater than about twice the trough (24 hour) response, suggesting some attenuation of response at 24 hours, presumably due to a fall in blood terazosin concentrations at the end of the dose interval. this explanation is not established with certainty, however, and is not consistent with the similarity of blood pressure response to once daily and twice daily dosing and with the absence of an observed dose-response relationship over a range of 5 to 20 mg, i.e., if blood concentrations had fallen to the point of providing less than full effect at 24 hours, a shorter dosing interval or larger dose should have led to increased response. further dose response and dose duration studies are being carried out. blood pressure should be measured at the end of the dose interval; if response is not satisfactory, patients may be tried on a larger dose or twice daily dosing regimen. the latter should also be considered if possibly blood pressure-related side effects, such as dizziness, palpitations, or orthostatic complaints, are seen within a few hours after dosing. the greater blood pressure effect associated with peak plasma concentrations (first few hours after dosing) appears somewhat more position-dependent (greater in the erect position) than the effect of terazosin at 24 hours and in the erect position there is also a 6 to 10 beat per minute increase in heart rate in the first few hours after dosing. during the first 3 hours after dosing 12.5% of patients had a systolic pressure fall of 30 mmhg or more from supine to standing, or standing systolic pressure below 90 mmhg with a fall of at least 20 mmhg, compared to 4% of a placebo group. there was a tendency for patients to gain weight during terazosin therapy. in placebo-controlled monotherapy trials, male and female patients receiving terazosin gained a mean of 1.7 and 2.2 pounds respectively, compared to losses of 0.2 and 1.2 pounds respectively in the placebo group. both differences were statistically significant. during controlled clinical trials, patients receiving terazosin monotherapy had a small but statistically significant decrease (a 3% fall) compared to placebo in total cholesterol and the combined low-density and very-low-density lipoprotein fractions. no significant changes were observed in high-density lipoprotein fraction and triglycerides compared to placebo. analysis of clinical laboratory data following administration of terazosin suggested the possibility of hemodilution based on decreases in hematocrit, hemoglobin, white blood cells, total protein and albumin. decreases in hematocrit and total protein have been observed with alpha-blockade and are attributed to hemodilution. image description image description image description pharmacokinetics terazosin hydrochloride administered as terazosin capsules is essentially completely absorbed in man. administration of capsules immediately after meals had a minimal effect on the extent of absorption. the time to reach peak plasma concentration however, was delayed by about 40 minutes. terazosin has been shown to undergo minimal hepatic first-pass metabolism and nearly all of the circulating dose is in the form of parent drug. the plasma levels peak about one hour after dosing, and then decline with a half-life of approximately 12 hours. in a study that evaluated the effect of age on terazosin pharmacokinetics, the mean plasma half-lives were 14 and 11.4 hours for the age group ≥ 70 years and the age group of 20 to 39 years, respectively. after oral administration the plasma clearance was decreased by 31.7% in patients 70 years of age or older compared to that in patients 20 to 39 years of age. the drug is 90 to 94% bound to plasma proteins and binding is constant over the clinically observed concentration range. approximately 10% of an orally administered dose is excreted as parent drug in the urine and approximately 20% is excreted in the feces. the remainder is eliminated as metabolites. impaired renal function had no significant effect on the elimination of terazosin, and dosage adjustment of terazosin to compensate for the drug removal during hemodialysis (approximately 10%) does not appear to be necessary. overall, approximately 40% of the administered dose is excreted in the urine and approximately 60% in the feces. the disposition of the compound in animals is qualitatively similar to that in man.

Pharmacodynamics:

Pharmacodynamics a. benign prostatic hyperplasia (bph) the symptoms associated with bph are related to bladder outlet obstruction, which is comprised of two underlying components: a static component and a dynamic component. the static component is a consequence of an increase in prostate size. over time, the prostate will continue to enlarge. however, clinical studies have demonstrated that the size of the prostate does not correlate with the severity of bph symptoms or the degree of urinary obstruction. the dynamic component is a function of an increase in smooth muscle tone in the prostate and bladder neck, leading to constriction of the bladder outlet. smooth muscle tone is mediated by sympathetic nervous stimulation of alpha-1 adrenoceptors, which are abundant in the prostate, prostatic capsule and bladder neck. the reduction in symptoms and improvement in urine flow rates following administration of terazosin is related to relaxation of smooth muscle produced by blockade of alpha-1 adrenoceptors in the bladder neck and prostate. because there are relatively few alpha-1 adrenoceptors in the bladder body, terazosin is able to reduce the bladder outlet obstruction without affecting bladder contractility. terazosin has been studied in 1222 men with symptomatic bph. in three placebo-controlled studies, symptom evaluation and uroflowmetric measurements were performed approximately 24 hours following dosing. symptoms were quantified using the boyarsky index. the questionnaire evaluated both obstructive (hesitancy, intermittency, terminal dribbling, impairment of size and force of stream, sensation of incomplete bladder emptying) and irritative (nocturia, daytime frequency, urgency, dysuria) symptoms by rating each of the 9 symptoms from 0 to 3, for a total score of 27 points. results from these studies indicated that terazosin statistically significantly improved symptoms and peak urine flow rates over placebo as follows: symptom score (range 0-27) peak flow rate (ml/sec) n mean baseline mean change (%) n mean baseline mean change (%) study 1 (10 mg) a titration to fixed dose (12 wks) placebo terazosin 55 54 9.7 10.1 -2.3 (24) -4.5 (45) * 54 52 10.1 8.8 +1.0 (10) +3.0 (34) * study 2 (2, 5, 10, 20 mg) b titration to response (24 wks) placebo terazosin 89 85 12.5 12.2 -3.8 (30) -5.3 (43) * 88 84 8.8 8.4 +1.4 (16) +2.9 (35) * study 3 (1, 2, 5, 10 mg) c titration to response (24 wks) placebo terazosin 74 73 10.4 10.9 -1.1 (11) -4.6 (42) * 74 73 8.8 8.6 +1.2 (14) +2.6 (30) * a highest dose 10 mg shown. b 23% of patients on 10 mg, 41% of patients on 20 mg. c 67% of patients on 10 mg. * significantly (p ≤ 0.05) more improvement than placebo. in all three studies, both symptom scores and peak urine flow rates showed statistically significant improvement from baseline in patients treated with terazosin from week 2 (or the first clinic visit) and throughout the study duration. analysis of the effect of terazosin on individual urinary symptoms demonstrated that compared to placebo, terazosin significantly improved the symptoms of hesitancy, intermittency, impairment in size and force of urinary stream, sensation of incomplete emptying, terminal dribbling, daytime frequency and nocturia. global assessments of overall urinary function and symptoms were also performed by investigators who were blinded to patient treatment assignment. in studies 1 and 3, patients treated with terazosin had a significantly (p ≤ 0.001) greater overall improvement compared to placebo treated patients. in a short term study (study 1), patients were randomized to either 2, 5 or 10 mg of terazosin or placebo. patients randomized to the 10 mg group achieved a statistically significant response in both symptoms and peak flow rate compared to placebo (figure 1) . in a long-term, open-label, non-placebo controlled clinical trial, 181 men were followed for 2 years and 58 of these men were followed for 30 months. the effect of terazosin on urinary symptom scores and peak flow rates was maintained throughout the study duration (figures 2 and 3) : in this long-term trial, both symptom scores and peak urinary flow rates showed statistically significant improvement suggesting a relaxation of smooth muscle cells. although blockade of alpha-1 adrenoceptors also lowers blood pressure in hypertensive patients with increased peripheral vascular resistance, terazosin treatment of normotensive men with bph did not result in a clinically significant blood pressure lowering effect: mean changes in blood pressure from baseline to final visit in all double-blind, placebo-controlled studies normotensive patients dbp ≤ 90 mmhg hypertensive patients dbp >90 mmhg group n mean change n mean change sbp (mmhg) placebo terazosin 293 519 -0.1 -3.3 * 45 65 -5.8 -14.4 * dbp (mmhg) placebo terazosin 293 519 +0.4 -2.2 * 45 65 -7.1 -15.1 * * p ≤ 0.05 vs. placebo b. hypertension in animals, terazosin causes a decrease in blood pressure by decreasing total peripheral vascular resistance. the vasodilatory hypotensive action of terazosin appears to be produced mainly by blockade of alpha-1-adrenoceptors. terazosin decreases blood pressure gradually within 15 minutes following oral administration. patients in clinical trials of terazosin were administered once daily (the great majority) and twice daily regimens with total doses usually in the range of 5 to 20 mg/day, and had mild (about 77%, diastolic pressure 95 to 105 mmhg) or moderate (23%, diastolic pressure 105 to 115 mmhg) hypertension. because terazosin, like all alpha antagonists, can cause unusually large falls in blood pressure after the first dose or first few doses, the initial dose was 1 mg in virtually all trials, with subsequent titration to a specified fixed dose or titration to some specified blood pressure end point (usually a supine diastolic pressure of 90 mmhg). blood pressure responses were measured at the end of the dosing interval (usually 24 hours) and effects were shown to persist throughout the interval, with the usual supine responses 5 to 10 mmhg systolic and 3.5 to 8 mmhg diastolic greater than placebo. the responses in the standing position tended to be somewhat larger, by 1 to 3 mmhg, although this was not true in all studies. the magnitude of the blood pressure responses was similar to prazosin and less than hydrochlorothiazide (in a single study of hypertensive patients). in measurements 24 hours after dosing, heart rate was unchanged. limited measurements of peak response (2 to 3 hours after dosing) during chronic terazosin administration indicate that it is greater than about twice the trough (24 hour) response, suggesting some attenuation of response at 24 hours, presumably due to a fall in blood terazosin concentrations at the end of the dose interval. this explanation is not established with certainty, however, and is not consistent with the similarity of blood pressure response to once daily and twice daily dosing and with the absence of an observed dose-response relationship over a range of 5 to 20 mg, i.e., if blood concentrations had fallen to the point of providing less than full effect at 24 hours, a shorter dosing interval or larger dose should have led to increased response. further dose response and dose duration studies are being carried out. blood pressure should be measured at the end of the dose interval; if response is not satisfactory, patients may be tried on a larger dose or twice daily dosing regimen. the latter should also be considered if possibly blood pressure-related side effects, such as dizziness, palpitations, or orthostatic complaints, are seen within a few hours after dosing. the greater blood pressure effect associated with peak plasma concentrations (first few hours after dosing) appears somewhat more position-dependent (greater in the erect position) than the effect of terazosin at 24 hours and in the erect position there is also a 6 to 10 beat per minute increase in heart rate in the first few hours after dosing. during the first 3 hours after dosing 12.5% of patients had a systolic pressure fall of 30 mmhg or more from supine to standing, or standing systolic pressure below 90 mmhg with a fall of at least 20 mmhg, compared to 4% of a placebo group. there was a tendency for patients to gain weight during terazosin therapy. in placebo-controlled monotherapy trials, male and female patients receiving terazosin gained a mean of 1.7 and 2.2 pounds respectively, compared to losses of 0.2 and 1.2 pounds respectively in the placebo group. both differences were statistically significant. during controlled clinical trials, patients receiving terazosin monotherapy had a small but statistically significant decrease (a 3% fall) compared to placebo in total cholesterol and the combined low-density and very-low-density lipoprotein fractions. no significant changes were observed in high-density lipoprotein fraction and triglycerides compared to placebo. analysis of clinical laboratory data following administration of terazosin suggested the possibility of hemodilution based on decreases in hematocrit, hemoglobin, white blood cells, total protein and albumin. decreases in hematocrit and total protein have been observed with alpha-blockade and are attributed to hemodilution. image description image description image description

Pharmacokinetics:

Pharmacokinetics terazosin hydrochloride administered as terazosin capsules is essentially completely absorbed in man. administration of capsules immediately after meals had a minimal effect on the extent of absorption. the time to reach peak plasma concentration however, was delayed by about 40 minutes. terazosin has been shown to undergo minimal hepatic first-pass metabolism and nearly all of the circulating dose is in the form of parent drug. the plasma levels peak about one hour after dosing, and then decline with a half-life of approximately 12 hours. in a study that evaluated the effect of age on terazosin pharmacokinetics, the mean plasma half-lives were 14 and 11.4 hours for the age group ≥ 70 years and the age group of 20 to 39 years, respectively. after oral administration the plasma clearance was decreased by 31.7% in patients 70 years of age or older compared to that in patients 20 to 39 years of age. the drug is 90 to 94% bound to plasma proteins and binding is consta
nt over the clinically observed concentration range. approximately 10% of an orally administered dose is excreted as parent drug in the urine and approximately 20% is excreted in the feces. the remainder is eliminated as metabolites. impaired renal function had no significant effect on the elimination of terazosin, and dosage adjustment of terazosin to compensate for the drug removal during hemodialysis (approximately 10%) does not appear to be necessary. overall, approximately 40% of the administered dose is excreted in the urine and approximately 60% in the feces. the disposition of the compound in animals is qualitatively similar to that in man.

How Supplied:

How supplied terazosin capsules, usp 1 mg, are available as size 3 white opaque cap and body hard gelatin capsules, imprinted with "735" on the cap and "1 mg" on the body in black ink, packaged in bottles of 90 capsules, ndc # 62135-458-90. terazosin capsules, usp 2 mg, are available as size 3 yellow opaque cap and white opaque body hard gelatin capsules, imprinted with "736" on the cap and "2 mg" on the body in black ink, packaged in bottles of 90 capsules, ndc # 62135-459-90. terazosin capsules, usp 5 mg, are available as size 3 swedish orange opaque cap and white opaque body hard gelatin capsules, imprinted with "737" on the cap and "5 mg" on the body in black ink, packaged in bottles of 90 capsules, ndc # 62135-460-90. terazosin capsules, usp 10 mg, are available as size 3 aqua blue opaque cap and white opaque body hard gelatin capsules, imprinted with “738” on the cap and “10 mg” on the body in black ink, packaged in bottles of 90 capsules, ndc # 62135-461-90.
pharmacist: dispense in a tight, light-resistant container as defined in the usp, with a child-resistant closure (as required). store at 20° to 25°c (68° to 77°f) [see usp controlled room temperature]. protect from light and moisture manufactured for: chartwell rx, llc. congers, ny 10920 l71232 revised 02/2023

Package Label Principal Display Panel:

Package label.principal display panel terazosin capsules, usp 1mg - ndc 62135-458-90 - 90s bottle label terazosin capsules, usp 2mg - ndc 62135-459-90 - 90s bottle label terazosin capsules, usp 5mg - ndc 62135-460-90 - 90s bottle label terazosin capsules, usp 10mg - ndc 62135-461-90 - 90s bottle label image description image description image description image description


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