BPH Drug Comparison Tool
High Selectivity
Tamsulosin (Flomax)
0.4 mg daily
Highly prostate-selective, minimal blood-pressure drop
- Ejaculatory disorders
- Mild headache
- Nasal congestion
Minimal ↓ BP Impact
Medium Selectivity
Terazosin (Hytrin)
1–10 mg daily
Proven long-term safety, dual-purpose for blood-pressure control
- Dizziness
- Orthostatic hypotension
- Fatigue
Moderate ↓ BP Impact
Medium Selectivity
Alfuzosin (Uroxatral)
10 mg daily
Lower incidence of blood-pressure related side-effects
- Dizziness (less)
- Headache
- Nausea
Low ↓ BP Impact
Low Selectivity
Cardura (Doxazosin)
1–4 mg daily
Works for both BPH and hypertension, but causes more dizziness
- Dizziness
- Headache
- Fatigue
- Ankle edema
Significant ↓ BP Impact
Low Selectivity
Prazosin (Minipress)
1–5 mg nightly
Rarely used for BPH, less prostate-specific
- Pronounced dizziness
- Postural hypotension
High ↓ BP Impact
Recommended Option:
Why This Choice:
When treating benign prostatic hyperplasia (BPH), Cardura is a brand name for doxazosin, an alpha‑1 adrenergic blocker that relaxes prostate and bladder neck muscles, easing urine flow and lowering blood pressure.
If you’ve been prescribed Cardura or are looking at alternatives, you’re probably weighing effectiveness, side‑effects, dosing convenience, and cost. Below you’ll find a straight‑to‑the‑point guide that lets you compare Cardura with the most common BPH alternatives, so you can decide what fits your lifestyle and health profile.
Key Takeaways
- Cardura (doxazosin) works for both BPH and hypertension, but may cause more dizziness than some newer drugs.
- Tamsulosin is highly selective for prostate receptors, often causing fewer blood‑pressure drops.
- Terazosin and alfuzosin sit in the middle - similar efficacy to Cardura with slightly different side‑effect profiles.
- Prazosin is rarely used for BPH today because it’s less prostate‑specific.
- Choosing the right drug depends on your cardiovascular health, tolerance for side‑effects, and dosing preferences.
What Is Cardura (Doxazosin)?
Doxazosin belongs to the alpha‑1 blocker class. It blocks alpha‑1 receptors in smooth muscle, leading to two main actions:
- Relaxation of the prostate and bladder neck, improving urine flow.
- Vasodilation of blood vessels, lowering systemic blood pressure.
Typical dosing for BPH starts at 1mg once daily, often increased to 4mg after a week if tolerated. For hypertension, the starting dose is the same but may be titrated up to 8mg.
Common side‑effects include:
- Dizziness or light‑headedness (especially after the first dose)
- Headache
- Fatigue
- Swelling of ankles
Because it affects blood pressure, doctors usually advise taking the first dose at bedtime and monitoring blood pressure closely during the first two weeks.
Top Alternatives to Cardura
Below are the most frequently prescribed BPH medications, each with its own profile.
Tamsulosin (Flomax)
Tamsulosin is a highly prostate‑selective alpha‑1 blocker. It targets the α1‑A and α1‑D subtypes, which dominate in the prostate, sparing most vascular receptors. This selectivity means fewer blood‑pressure drops.
- Usual dose: 0.4mg once daily, taken after the same meal each day.
- Key benefits: Less dizziness, rapid symptom relief (often within a week).
- Typical side‑effects: Ejaculatory disorders, mild headache, nasal congestion.
Terazosin (Hytrin)
Terazosin shares the same mechanism as Cardura but is slightly more selective for prostate tissue. It’s used for both BPH and hypertension.
- Usual dose: 1mg once daily, titrated up to 10mg.
- Benefits: Proven long‑term safety, dual‑purpose for blood‑pressure control.
- Side‑effects: Similar to Cardura - dizziness, orthostatic hypotension, fatigue.
Alfuzosin (Uroxatral)
Alfuzosin is a non‑selective alpha‑1 blocker with a slower onset, marketed as a “once‑daily” option for men with BPH.
- Usual dose: 10mg once daily after the evening meal.
- Benefits: Lower incidence of blood‑pressure related side‑effects, convenient bedtime dosing.
- Side‑effects: Dizziness (less than Cardura), headache, nausea.
Prazosin (Minipress)
Prazosin was originally an antihypertensive and is rarely a first‑line BPH treatment due to weaker prostate selectivity. It may be used when other drugs are unavailable.
- Usual dose: 1mg at bedtime, titrated up to 5mg.
- Benefits: Cheap and widely available.
- Side‑effects: Pronounced postural hypotension, higher rate of dizziness.
Side‑Effect Profile Comparison
| Drug | Prostate selectivity | Blood‑pressure impact | Common side‑effects | Typical dose for BPH |
|---|---|---|---|---|
| Cardura (Doxazosin) | Low | Significant ↓ | Dizziness, headache, fatigue, ankle edema | 1‑4mg daily |
| Tamsulosin | High | Minimal ↓ | Ejaculatory disorder, mild headache, nasal congestion | 0.4mg daily |
| Terazosin | Medium | Moderate ↓ | Dizziness, orthostatic hypotension, fatigue | 1‑10mg daily |
| Alfuzosin | Medium | Low ↓ | Dizziness (less), headache, nausea | 10mg daily |
| Prazosin | Low | High ↓ | Pronounced dizziness, postural hypotension | 1‑5mg nightly |
How to Choose the Right Drug for You
Consider the following decision points when talking to your GP or urologist:
- Do you have hypertension? If you need blood‑pressure control, Cardura or terazosin can kill two birds with one stone. Tamsulosin won’t help with hypertension.
- Are you prone to dizziness? Tamsulosin and alfuzosin have the lowest risk of orthostatic drops. If you’ve experienced falls, steer clear of non‑selective blockers.
- Cost matters? Generic doxazosin and prazosin are usually the cheapest. However, if side‑effects cause doctor visits, the cheaper drug may end up costing more.
- Do you have sexual‑function concerns? Tamsulosin is notorious for causing retrograde ejaculation, while alfuzosin and doxazosin have milder effects.
- Convenience of dosing? All alternatives are once‑daily, but many clinicians recommend taking tamsulosin after the same meal each day to keep blood levels stable.
Write down your answers, bring them to the appointment, and ask the doctor to match the drug profile with your health priorities.
Frequently Asked Questions
Can I switch from Cardura to Tamsulosin easily?
Yes. Doctors usually overlap the last dose of Cardura with the first dose of tamsulosin for a day or two, then stop Cardura. Monitoring blood pressure during the switch is important because tamsulosin has less impact on hypertension.
Why does Cardura cause ankle swelling?
Doxazosin dilates peripheral blood vessels, which can increase fluid accumulation in the lower limbs, especially if you stand for long periods. Elevating the legs and wearing compression stockings can help.
Is Cardura safe for men over 80?
It can be used, but the starting dose should be lower (0.5mg) and increased very slowly. Older men are more prone to orthostatic hypotension, so close monitoring is essential.
Do any of these drugs improve prostate size?
Alpha‑blockers, including Cardura, mainly relax muscle tone; they do not shrink the prostate. For size reduction, 5‑alpha‑reductase inhibitors like finasteride are needed, often in combination with an alpha‑blocker.
Can Cardura be taken with other medications?
Yes, but watch for interactions with PDE‑5 inhibitors (e.g., sildenafil) - the combination can cause a sudden blood‑pressure fall. Also avoid combining with other strong antihypertensives without doctor supervision.
What should I do if I miss a dose?
Take the missed tablet as soon as you remember, unless it’s already afternoon. If it’s near the time of your next dose, skip the missed one and continue with the regular schedule. Never double‑dose.
Bottom Line
Cardura is a solid, dual‑purpose option for men juggling BPH and high blood pressure, but its non‑selective nature brings more dizziness and swelling. Tamsulosin, alfuzosin and terazosin each trade off a bit of blood‑pressure control for smoother tolerability. Your personal health profile - especially cardiovascular status and sensitivity to side‑effects - should drive the final choice.
Talk openly with your healthcare provider, bring your symptom diary, and don’t hesitate to ask for a trial period. Switching drugs is common, and finding the right fit can dramatically improve quality of life.
Joery van Druten
When you’re comparing Cardura to the other alpha‑blockers, the biggest thing to watch is the blood‑pressure drop. Doxazosin hits the vascular receptors strongly, so dizziness and ankle edema are pretty common, especially after the first few doses. Tamsulosin and Alfuzosin are more prostate‑selective, which is why patients usually feel less light‑headed. If you also need hypertension control, Cardura or Terazosin can kill two birds with one stone, but you’ll have to monitor your numbers closely. Starting at 1 mg and titrating slowly usually keeps the side‑effects manageable.