α1 adrenoceptor blocker Pregnancy: Animal experiments indicate no teratogenic effects, but indoramin tablets should not be prescribed for pregnant women unless considered essential by the physician. No data on excretion in human milk; should not be administered during lactation unless clinically justifiable in the physician's judgement.

Indoramin

Brand names: Doralese

Indoramin is a selective alpha-1 adrenoceptor antagonist used to relieve voiding symptoms in benign prostatic hyperplasia and, less commonly, in hypertension.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: Benign prostatic hyperplasia: 20 mg twice daily; the dose may be increased in 20 mg increments at two-weekly intervals if required

Route: Oral

Frequency: Twice daily

Max: 100 mg per day

Elderly: 20 mg at night may be adequate. Clearance of indoramin may be affected in the elderly — a reduced dose and/or reduced frequency of dosing may be sufficient in some elderly patients (§4.4). Paediatric population: not recommended. Caution should be observed in prescribing indoramin for patients with hepatic or renal insufficiency, a history of depression, Parkinson's disease or epilepsy; incipient cardiac failure should be controlled before treatment. Source: UK SPC for Doralese Tiltab Tablets 20 mg (eMC product 6666), §4.2 posology heading 'Hyperplasia'.

Dose adjustments

Renal

No numerical dose adjustment is stated. §4.4: caution should be observed in prescribing indoramin for patients with hepatic or renal insufficiency.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to the active substance or to any of the excipients
Patients with established heart failure
Patients already under treatment with a monoamine oxidase inhibitor

Side effects

Drowsiness or sedation, particularly on starting treatment or if the dose is increased too rapidly
Dry mouth, nasal congestion and weight gain (less common)
Dizziness and hypotension including postural hypotension, with or without syncope (less common)
Failure of ejaculation (less common)
Depression, fatigue and headache (less common); rarely exacerbation of Parkinson's disease; rarely hypersensitivity reactions including rash and pruritus

Interactions

Monoamine oxidase (MAO) inhibitors — do not use indoramin in patients being treated with an MAO inhibitor
Antihypertensive drugs and drugs with hypotensive properties (e.g. antidepressants, anxiolytics, hypnotics, moxisylyte) — indoramin may enhance their hypotensive action; titration of the dose of the latter may be needed
Alcohol — can increase both the rate and extent of absorption of indoramin, although no untoward effects have been reported at recommended doses
Alpha-1 blockers as a class have been associated with Intraoperative Floppy Iris Syndrome — current or past use should be made known to the ophthalmic surgeon in advance of cataract surgery (§4.4)

Clinical monograph

How it works

It selectively blocks post-synaptic alpha-1 adrenoceptors, relaxing smooth muscle in the bladder neck and prostate to reduce outflow obstruction.

Prescribing in practice

It is markedly sedating and can impair driving and skilled-task performance, particularly on initiation and when combined with alcohol or other CNS depressants.
It may cause first-dose and postural hypotension, so introduce it cautiously, especially in older patients.
Avoid in patients with established heart failure and use caution in Parkinson's disease and depression, in line with the SPC.

Monitoring

Monitor blood pressure (including lying and standing where relevant) and review symptom response and tolerability after initiation and dose changes.

Counselling the patient

This medicine can make you drowsy; do not drive or operate machinery until you know how it affects you, and avoid alcohol.
Rise slowly from sitting or lying to reduce dizziness.
Report fainting, palpitations or persistent drowsiness.

Evidence & guidelines

Alpha-1 blockade is an established option for symptomatic benign prostatic hyperplasia, supported by NICE guidance on lower urinary tract symptoms in men.

Reference: NICE NG134; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways