Cardura (doxazosin) is a medication many people take to manage high blood pressure or enlarged prostate (BPH). But it’s not the only option. If you’re on Cardura and wondering if there’s something better, safer, or cheaper - you’re not alone. Thousands of people switch each year because of side effects, cost, or lack of results. This guide breaks down how Cardura stacks up against its most common alternatives, so you know exactly what to ask your doctor next.
How Cardura (Doxazosin) Actually Works
Cardura belongs to a class of drugs called alpha-1 blockers. It relaxes muscles in the blood vessels and prostate, which lowers blood pressure and eases urine flow. Most people start with 1 mg daily and slowly increase to 2-8 mg, depending on how their body responds. It’s usually taken once a day, often in the morning to avoid dizziness from sudden drops in blood pressure.
Studies show Cardura reduces systolic blood pressure by about 8-12 mmHg on average. For BPH, it improves urine flow and reduces nighttime trips to the bathroom in roughly 60-70% of users. But side effects? Dizziness (especially when standing up), fatigue, and low blood pressure happen in up to 20% of people. That’s why many look for alternatives.
Tamsulosin (Flomax): The Most Common Switch
If you’re taking Cardura for an enlarged prostate, chances are your doctor has already mentioned tamsulosin - sold as Flomax. It’s the most popular alternative for BPH. Unlike Cardura, tamsulosin is more selective. It targets only the muscles in the prostate and bladder neck, not those in blood vessels. That means less risk of dizziness or fainting.
Studies comparing tamsulosin and doxazosin show both improve urinary symptoms equally well. But tamsulosin causes significantly fewer cases of low blood pressure. One 2023 meta-analysis found dizziness occurred in 8% of tamsulosin users versus 18% of doxazosin users. If you’re older, have low blood pressure, or live alone, tamsulosin might be safer.
Downside? Tamsulosin doesn’t help with high blood pressure at all. So if you have both BPH and hypertension, Cardura still has an edge. But if you’re only treating prostate symptoms, tamsulosin is often the better first choice.
Terazosin (Hytrin): The Older Sibling
Terazosin is almost identical to doxazosin - same drug class, same mechanism. The main difference? How long it lasts in your body. Terazosin has a shorter half-life, so it needs to be taken once or sometimes twice daily. Cardura lasts longer, so one pill a day is usually enough.
In practice, both drugs work similarly for blood pressure and BPH. A 2022 review in the Journal of Urology found no major difference in effectiveness between the two. But terazosin tends to cause slightly more dizziness in the first few weeks. That’s because it hits blood vessels harder right away.
Terazosin is often cheaper than Cardura, especially as a generic. If cost is your biggest concern and you can handle mild dizziness at first, terazosin is a solid backup. But if you want simplicity - one pill, once a day - Cardura wins.
Finasteride (Propecia, Proscar): For Long-Term Prostate Shrinkage
Finasteride doesn’t relax muscles. Instead, it shrinks the prostate over time by blocking the hormone DHT. It’s not a quick fix. It takes 3-6 months to see results. But once it works, the effects last as long as you keep taking it.
Studies show finasteride reduces prostate size by 20-30% after a year. That means fewer urinary symptoms and lower risk of needing surgery later. It’s especially useful for men with very large prostates (over 40 mL). Cardura gives fast relief but doesn’t change the size of the gland.
Combining finasteride with Cardura is common. One large trial found this combo reduced the risk of acute urinary retention by 57% compared to either drug alone. If you’re young, have a big prostate, and want to avoid surgery down the road, this combo might be worth discussing.
Downside? Finasteride can lower sex drive and cause erectile dysfunction in about 5-10% of users. It also takes months to work. So it’s not ideal if you need fast relief.
Silodosin (Rapaflo): For Stronger Urinary Relief
Silodosin is newer than tamsulosin and even more selective. It targets only the prostate and bladder neck, with almost no effect on blood pressure. That makes it a great option for men who can’t tolerate dizziness or low blood pressure.
It’s slightly more effective than tamsulosin at improving urine flow. One 2024 study showed silodosin improved peak urine flow by 3.2 mL/sec on average, compared to 2.7 mL/sec with tamsulosin. It also works faster - some men notice improvement in just a few days.
But it has a unique side effect: retrograde ejaculation. Semen goes backward into the bladder instead of out during orgasm. It’s harmless but can be unsettling. If you’re not planning to have children, this might not matter. But if fertility is a concern, this drug isn’t ideal.
Other Options: Beta Blockers, Calcium Channel Blockers, and More
If you’re on Cardura for high blood pressure, your doctor might consider switching you to a different class of drug entirely. Beta blockers like atenolol or calcium channel blockers like amlodipine are common alternatives.
But here’s the catch: alpha blockers like Cardura are no longer first-line for high blood pressure in most guidelines. The American Heart Association now recommends ACE inhibitors, ARBs, or thiazide diuretics as starting points. Alpha blockers are usually reserved for people who also have BPH.
So if you only have high blood pressure - no prostate issues - Cardura might not be the best fit. Amlodipine, for example, lowers blood pressure just as well, without the dizziness or sexual side effects. It’s also cheaper and safer for older adults.
Cost Comparison: What’s Cheaper Today?
Price matters. Here’s what you’re likely to pay out-of-pocket in the U.S. and New Zealand as of 2025:
| Drug | Brand Name | Typical Dose | Approx. Cost (USD) | Approx. Cost (NZD) |
|---|---|---|---|---|
| Doxazosin | Cardura | 4 mg | $15-$25 | $22-$35 |
| Tamsulosin | Flomax | 0.4 mg | $10-$20 | $15-$28 |
| Terazosin | Hytrin | 5 mg | $8-$18 | $12-$25 |
| Finasteride | Proscar | 5 mg | $12-$22 | $18-$30 |
| Silodosin | Rapaflo | 8 mg | $70-$100 | $100-$140 |
Terazosin is the cheapest. Tamsulosin is a good balance of price and safety. Silodosin is effective but expensive. Cardura sits in the middle - not the cheapest, not the safest, but useful if you need to treat both conditions.
When to Stick With Cardura
You should stay on Cardura if:
- You have both high blood pressure and BPH, and it’s working well for both.
- You’ve tried alternatives and had bad side effects or no improvement.
- Your doctor has carefully adjusted your dose and you rarely feel dizzy.
Many people assume switching is better - but if Cardura works and you tolerate it, there’s no need to change. The goal isn’t to find the “best” drug - it’s to find the one that works for you.
When to Ask for a Change
Time to talk to your doctor if:
- You feel lightheaded when standing up - especially if you’ve fallen or nearly fallen.
- Your blood pressure is too low (under 100/60) and you’re tired all the time.
- You’re paying over $30 a month for Cardura and your alternatives cost less.
- You only have BPH and aren’t being treated for high blood pressure.
Don’t stop Cardura suddenly. It can cause a rebound spike in blood pressure. Always taper under medical supervision.
What Your Doctor Won’t Always Tell You
Most doctors start with Cardura because it’s been around for decades and they know how to use it. But guidelines have changed. The 2023 European Association of Urology guidelines now recommend tamsulosin or silodosin as first-line for BPH - not doxazosin.
Also, many patients don’t realize you can combine drugs. If you’re on Cardura for blood pressure but still have urinary symptoms, adding tamsulosin might help - without increasing dizziness risk too much. Or if you’re on finasteride and still struggling, a low dose of tamsulosin can be added on.
There’s no one-size-fits-all. Your age, other medications, prostate size, and lifestyle all matter.
Is Cardura better than Flomax for BPH?
Flomax (tamsulosin) is usually better for BPH alone because it causes fewer side effects like dizziness and low blood pressure. Cardura works for both BPH and high blood pressure, so if you have both, it might still be the right choice. But if you only have prostate issues, Flomax is safer and just as effective.
Can I switch from Cardura to tamsulosin on my own?
No. Stopping Cardura suddenly can cause a dangerous rise in blood pressure. Always talk to your doctor first. They’ll likely reduce your dose gradually before starting tamsulosin. Never make changes without medical advice.
Does doxazosin cause weight gain?
Weight gain isn’t a common side effect of doxazosin. Some people report feeling less active due to fatigue, which might lead to weight gain over time. But the drug itself doesn’t directly cause it. If you’re gaining weight, look at diet, activity level, or other medications you’re taking.
How long does it take for Cardura to work for BPH?
Most people notice improved urine flow within 1-2 weeks. Full benefits usually take 4-6 weeks. If you don’t see improvement after two months, talk to your doctor - you might need a different treatment.
Is there a natural alternative to Cardura?
No natural remedy has been proven to work as reliably as Cardura for high blood pressure or BPH. Saw palmetto is sometimes used for prostate symptoms, but studies show it’s no better than a placebo. Lifestyle changes - like reducing alcohol, avoiding caffeine at night, and staying active - can help, but they won’t replace medication if your symptoms are moderate to severe.
Next Steps: What to Do Today
If you’re on Cardura and wondering if it’s right for you, start here:
- Write down your symptoms: Are you still having trouble urinating? Do you feel dizzy when standing?
- Check your blood pressure logs - are you consistently below 110/70?
- Look at your last prescription cost. Is it over $25 a month?
- Make a list of your other medications. Could any be interacting with Cardura?
- Book an appointment with your doctor. Ask: “Is there a safer or cheaper option for me?”
There’s no shame in asking. Millions of people switch medications every year - not because something’s wrong with them, but because better options exist. You deserve to feel good, not dizzy, and not overpaying for a drug that might not be the best fit anymore.
Carly Smith
Cardura made me dizzy as hell like 20 minutes after taking it i nearly crashed my car just walking to the fridge
Kurt Stallings
Alpha blockers are outdated. Modern hypertension guidelines recommend ACEi or ARBs first. Cardura’s just a legacy drug for docs who still use fax machines.
Angie Creed
It’s not about the drug-it’s about the system. We’ve been conditioned to believe that a pill can fix everything. But what if the real problem is our disconnect from nature? Our bodies were never meant to live in fluorescent-lit cubicles, swallowing chemicals to mask symptoms we created by ignoring sleep, movement, and stillness.
Cardura? Tamsulosin? They’re just Band-Aids on a bullet wound. We treat the prostate like a broken appliance instead of listening to what the body is screaming. The real alternative isn’t another drug-it’s radical self-awareness. And yes, I’ve tried saw palmetto. It didn’t work. But the silence I found after stopping all meds? That did.
Michael Ferguson
Look, I’ve been on Cardura for six years and I’m not gonna lie-I was skeptical when my doctor first prescribed it. But here’s the thing: I had both hypertension and BPH, and nothing else worked without wrecking my blood pressure or making me feel like a zombie. I tried tamsulosin, and sure, the dizziness was less-but I still had to pee every hour at night. Then I added finasteride. That’s when things changed. My prostate shrank, my flow improved, and I stopped waking up five times a night. But let me tell you, the sexual side effects? Real. I lost my libido for months. My wife thought I was cheating. I had to sit her down and explain that it wasn’t her, it was the DHT blocker. We got through it. But here’s what no one tells you: the combo works, but it’s not easy. You have to be patient, you have to be honest with your partner, and you have to accept that some trade-offs are worth it if you want to sleep through the night again. Also, don’t forget to hydrate. Dehydration makes the dizziness worse. And yeah, I know the cost is brutal, but my insurance covers it now after I appealed. If you’re struggling, call your pharmacy and ask for patient assistance programs. They’re real. I used one. And I’m still here.
Patrick Klepek
So Cardura’s not the ‘best’… but it’s the one that didn’t make me pass out while trying to put on socks. Funny how ‘best’ is always relative, isn’t it?
Caden Little
Hey everyone-just wanted to say if you’re on Cardura and feeling dizzy, don’t panic. Sit down. Drink water. Wait 15 mins. Most of the time it passes. Also, if you’re on it for BPH and not BP, talk to your doc about switching to tamsulosin-it’s way gentler. And if cost is an issue, terazosin is basically the same drug but cheaper. I switched from Cardura to terazosin last year and saved $18/month. No more fainting spells, same results. You got this 💪
Sebastian Brice
Wow, I just read this whole thing and I’m reminded how weird it is that we treat medicine like a menu. ‘I’ll have the dizziness with a side of retrograde ejaculation, please.’ We’re so quick to swap drugs like they’re interchangeable snacks, but the body doesn’t work that way. I’ve been on finasteride + tamsulosin for 18 months. It’s not perfect. I still get tired. I still wake up once a night. But I haven’t had to go to the urologist since. And honestly? That’s enough. Maybe ‘better’ isn’t about the drug. Maybe it’s about finding the version of yourself that can live with the trade-offs.
Jim Aondongu
Cardura is just a corporate scam to keep you dependent on pills. In Nigeria we use herbal mixtures and it works better without side effects. Why do you trust Big Pharma when your own body knows what to do