Switching from doxazosin XL tablets to doxazosin standard release tablets

Both doxazosin standard release tablets and doxazosin XL tablets provide effective blood pressure control and both are effective in reducing the clinical symptoms of benign prostatic hyperplasia (BPH) and improving maximum urinary flow rate.

NICE guidelines do not identify any benefits of doxazosin XL tablets compared to doxazosin standard release tablets and there is no compelling evidence from studies of any clinically significant differences between the two products in patients with hypertension or BPH.

In 2017, NHS England published a document which includes advice to prescribers to switch doxazosin XL tablets to doxazosin standard release tablets. This is due to the significantly higher cost of doxazosin XL tablets and the lack of benefits in relevant clinical guidelines for the modified release preparation.

In this document, we suggest three possible strategies to convert patients from doxazosin XL to doxazosin standard release tablets and how to monitor and advise patients when switching.

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