Nearly collapsed - Doxazosin

Harry Bloomfield wrote:

Bob Henson wrote on 04/02/2018 :
I hope that was the sustained release preparation? That is technically the
correct starting dose for sustained release, but not for the ordinary
preparation, as others have commented. If it were the plain tablet there is
a process of titrating the dose upwards from the lowest over several weeks
that should be followed to avoid the possibility of what you describe.

If it was the sustained release tablet, then I trust you didn't crush or
break them? Depending on how the particular preparation is made, that could
produce the effect you describe by releasing almost the whole dose at once
instead of slowly over a whole day.

The box (I got two boxes) says 28x Doxazosin 4mg calendar pack tablets,
with the trade name Teva UK. I cannot see any mention of 'sustained
release' anywhere on the pack, or the instructions.

I do struggle with swallowing so I crushing and taking in water, any of
the tablets which can be crushed. I asked the pharmacist if these could
be crushed, he said 'I wouldn't' so I struggled to get them down whole.
I am now thinking that some serious errors occurred with this
prescription - both the doctor and pharmacist...

I'd have to see the box to be sure, but it should have "XL" or something
like that on it if it's the sustained/modified release form. Teva's
sustained release version is called Larbex XL 4mg tablets.

If the doctor prescribed 4mg *ordinary* tablets it would at the very least
be quite unusual to give you 4mg at once - the build up should be from
0.5mg or 1mg building up over some weeks to a level that produced the
effect he wanted. I would have been quite surprised if you *didn't* get
the symptoms you described at that initial dose. Even with a lower dose you
should have been advised to take the first dose sitting down and to stay
that way for a while - and then to get up slowly and carefully and
preferably with someone else around.

However, as you are already on a number of drugs it would seem your
hypertension is pretty intractable, so it is unlikely but possible that the
high dose was what was intended - it's hard to say without a full patient
history. That's of course, is the problem a pharmacist would have - he/she
can only work from the data on front of him/her and rarely has enough
access to patient data like your GP.

However, if the doctor *did* prescribe the sustained release form (you can
check that from your copy of your prescription) and you have got the
ordinary tablets then the pharmacy has made a dispensing error. Please
don't act on that without first checking carefully that an error *has*
actually been made - I'm only *guessing* from a distance with no visual
evidence whatever.

--
Bob
Tetbury, Gloucestershire, England

I asked Mother if I was a gifted child. She said they certainly wouldn't
have paid for me.