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Prazosin Side Effects, Uses, Interactions, Warnings, & More

Prazosin may cause adverse effects. Tell your doctor if any of those listed in the SPECIAL PRECAUTIONS section on the drug label are severe or do not go away. Continue to read more about prazosin side effects and how to treat withdrawals from the drug.

By We Level Up NJ Treatment Center | Editor Yamilla Francese | Clinically Reviewed By Lauren Barry, LMFT, MCAP, QS, Director of Quality Assurance | Editorial Policy | Research Policy | Last Updated: March 10, 2023

Prazosin (Oral)

Prazosin is a drug used to manage and treat hypertension or high blood pressure, benign prostatic hyperplasiam, anxiety, PTSD-associated nightmares, and the Raynaud phenomenon (a concern that causes declined blood flow to the fingers.)

Prazosin Side Effects

Prazosin is generally well-tolerated. However, like all medications, it can have side effects.

More common side effects of prazosin are:

  • Dizziness or lightheadedness.
  • Headaches.
  • Drowsiness or fatigue.
  • Nausea and Dry mouth.
  • Diarrhea and Constipation.
  • Blurred vision and problems with vision
  • Chest pains.
  • Tiredness.

Rare side effects of prazosin are:

  • Bloating, swelling, and inflamation.
  • Dark urine, yellow eyes, and skin.
  • Decreased sex drive and ability.
  • Stomach pain radiating to back.

More serious side effects of prazosin include:

  • Anxiety and Depression.
  • Rapid and irregular heartbeat
  • Fainting and shortness of breath.

How to Deal with Prazosin Side Effects?

If you experience any of these side effects, it is important to talk to your doctor. They may be able to adjust your dosage or switch you to a different medication. In rare cases, prazosin can also cause more serious side effects, such as chest pain or an irregular heartbeat. If you experience any of these symptoms, seek medical attention immediately.

Fainting Prazosin Side Effects 

Fainting or loss of consciousness can occur 30 to 90 minutes after taking the first dose. Prazosin is a quinazoline derivative that functions as a competitive alpha1-antagonist.

Prazosin’s most prevalent adverse effects are mild to moderate in severity. Several are caused by the drug’s neurological system effects, such as dizziness, sleepiness, and exhaustion, which are its most prevalent side effects.

Prazosin uses also includes, Orthostatic hypotension (low blood pressure when standing after sitting or lying down), dizziness, fainting, rapid loss of consciousness, and palpitations (tachycardia). Lightheadedness and lack of energy are all possible alpha-blockers and Prazosin side effects.

Prazosin Uses

What is prazosin used for? Prazosin (brand name is Minipress) is a prescription medication used to manage and treat hypertension, hyperplasia (increased cell production in normal tissue or organ), benign prostatic (prostate enlargement), PTSD-associated nightmares, and the Raynaud phenomenon. According to the National Institute of Health (NIH) [1], Prazosin is in an alpha-blocker class of medications. It relaxes the blood vessels so that blood can flow more quickly through the body. Prazosin comes only as a capsule taken orally.

Prazosin for Anxiety 

Prazosin is sometimes prescribed off-label for the treatment of anxiety disorder. Can prazosin cause anxiety? Prazosin has an average rating of 7.0 out of 10 from 20 ratings for treating anxiety and stress. 60% of reviewers reported a positive effect, while 25% reported an adverse effect. Does prazosin calm you down? Prazosin relaxes blood vessels in people with high blood pressure or heart failure.

Prazosin for PTSD

Prazosin has a calming effect that can help reduce anxiety and improve sleep in people with PTSD. However, it is important to note that the FDA does not specifically approve prazosin for treating anxiety disorder or PTSD.

According to research published by the National Center for Biotechnology Information (NCBI) [2], Prazosin may have effectively treated sleep problems related to post-traumatic stress disorder or PTSD. However, it’s still prescribed “off-label” for these conditions. Off-label refers to drug use for conditions not approved by the U.S. Food and Drug Administration (FDA).

If you are considering taking prazosin for anxiety or PTSD, it is important to talk to your doctor first to determine whether it is safe and appropriate for your situation. Your doctor may recommend other medications or therapies that are more appropriate for your needs.

PTSD Prazosin Side Effects

Post-traumatic stress disorder (PTSD) is a psychiatric disorder with symptoms that include insomnia due to hyperarousal and recurring nightmares. PTSD is a severe anxiety disorder that impacts a large percentage of the US population, particularly veterans.

There have been reports that prazosin, a commonly prescribed off-label drug, could be making suicidal thoughts worse for veterans suffering from PTSD. [3] A team of researchers from the Department of Veterans Affairs, seeking to collect more evidence, set out to study the sustained effectiveness of the treatment. They organized a large, lengthy, multisite trial—the most rigorous for prazosin research.

Prazosin was no better than a placebo. According to The Department of Veterans Affairs (VA) [4], for nightmares associated with PTSD, there is insufficient evidence to recommend or against using prazosin as mono- or augmentation treatment.

Prazosin Uses Off-label

Prazosin, off-label uses include an enlarged prostate, congestive heart failure, Raynaud’s disease, and PTSD-related sleep problems. Prazosin may not be as life-threatening as other drugs of abuse like benzodiazepines, opioids, heroin, cocaine, and meth, but this drug can still produce adverse side effects.

Prazosin Side Effects Warning

Remember that prazosin should always be taken exactly as your doctor prescribes, and you should never adjust your dose or stop taking it without consulting your doctor.

Commonly reported prazosin side effects include dizziness, dorwsiness, and syncope. Syncope is another word for fainting or passing out.
Commonly reported prazosin side effects include dizziness, dorwsiness, and syncope. Syncope is another word for fainting or passing out.

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Prazosin Abuse

Prazosin abuse has been a growing concern, a prescription drug on the market for over 20 years. Its use can cause uncomfortable prazosin side effects, from lightheadedness and vomiting to fainting and depression.

Is Prazosin Addictive?

If enough of this prescription medication is taken, it can produce a psychotropic effect. That result is enough to cause users to exceed their dosage to chase the same impact. Tolerance and dependence can immediately plunge into addiction when someone exhibits compulsive behaviors in seeking the drug. Prazosin abuse can lead to addiction.

Prazosin Drug Facts

What is Prazosin?

Prazosin is FDA-approved for hypertension alone or in combination with other antihypertensive agents. However, this medication is not a first-line agent based on current evidence-based guidelines.

Generic Name: Prazosin [ PRA-zoe-sin ]
Brand Name: Minipress
Dosage Form: Oral capsule (1 mg; 2 mg; 5 mg)
Drug Class: Antiadrenergic agents, peripherally acting

One phenomenon associated with Prazosin is known as the "first dose drug response," in which the Prazosin side effects – specifically orthostatic hypotension, dizziness, and drowsiness – are especially pronounced in the first dose.
One phenomenon associated with Prazosin is known as the “first dose drug response,” in which the Prazosin side effects – specifically orthostatic hypotension, dizziness, and drowsiness – are especially pronounced in the first dose.

Prazosin Side Effects

How long do prazosin side effects last? Prazosin side effects usually go away after a few days. To lower side effects, it’s best to take the first medication dose at bedtime.

  • Dizziness
  • Lightheadedness
  • Fainting
  • Fatigue
  • Low blood pressure
  • Headache
  • Rash
  • Hives
  • Itching
  • Rapid or irregular heartbeat
  • Difficulties breathing
  • Chest pains

Prazosin Overdose Risks

An overdose of prazosin may cause low blood pressure, dizziness, fainting, and other symptoms. Call emergency services immediately if you suspect someone has taken an overdose of prazosin.

It’s important to seek medical attention immediately, as an overdose of prazosin can be life-threatening.

The treatment for prazosin overdose typically involves supportive measures, like controlling blood pressure, and may also include pumping the stomach or using medications to counteract the effects of the drug.

Prazosin Side Effects Warnings

Prazosin is a medication that is generally safe when taken as prescribed, but like all medications, it can have potential risks and warnings. Some of the most important warnings to be aware of when taking prazosin include:

  1. Low blood pressure: Prazosin can cause a sudden drop in blood pressure, especially when standing up. This can cause dizziness, light-headedness, or even fainting. If you experience these symptoms, sitting or lying down is important until they pass.
  2. Allergic reaction: In rare cases, prazosin can cause severe allergies. If you experience hives, swelling, or difficulty breathing, seek medical attention immediately.
  3. Liver dysfunction: Prazosin may cause liver dysfunction in rare cases, so monitoring liver function while taking this medication is important.
  4. Kidney function impairment: Prazosin may also cause impairment in kidney function in some cases.
  5. Pregnancy and breastfeeding: Prazosin should only be used during pregnancy or breastfeeding if the potential benefits outweigh the possible risks.

It is crucial to discuss any potential risks and warnings with your doctor before beginning treatment with prazosin. Additionally, it is vital to take prazosin exactly as directed by your doctor and to report any unusual side effects or symptoms to your doctor immediately.

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PTSD & Prazosin Abuse Statistics

Post-traumatic stress disorder (PTSD) and substance use disorder (SUD) frequently co-occur in Veterans seeking VA care. Individuals suffering from PTSD and drug addiction can benefit from trauma-focused PTSD treatments, including Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT).


According to the US Department of Veterans Affairs, women with PTSD were 2.48 times more feasible to meet the criteria for alcohol addiction or dependency and 4.46 times more likely to meet the criteria for drug addiction or dependence than women without PTSD.

Source: US Department of V.A.


Among Veterans diagnosed with alcohol use disorder and another substance use disorder, the rate of PTSD diagnosis was 76%.

Source: US Department of V.A.

10 Years

During the past ten years, the number of Veterans with comorbid substance use disorder and PTSD in VA care has increased over three-fold.

Source: US Department of V.A.

In-deoth Serious Prazosin Side Effects Review

Call your physician immediately if you experience the following prazosin side effects. Adverse effects of prazosin and their symptoms can include:

  • Loss of consciousness (this can occur if you stand up too quickly after Sitting or lying down)
  • Abnormal speedy heartbeat
  • Depression
  • An erection lasting more than four hours
  • Swelling of your hands and feet
  • Difficulty breathing
  • Allergic reactions
  • Hives
  • Skin rash
  • Swelling of the lips, face, or tongue

Dangers of Recreational Prazosin Uses

Prazosin use isn’t life-threatening in the way that more potent substances like stimulants and opioids are. However, the recreational use of this drug can be dangerous. It can produce concerning prazosin side effects.

Does prazosin make you sleepy? For one, upon first use, prazosin can cause someone to experience lightheadedness, dizziness, and fainting if they get up too quickly from a lying-down position after taking the medication. Also, this drug can weaken the person to the point where operating machinery or driving a car becomes too dangerous.

Prazosin does not pose the addiction potential of sedative drugs such as Ambien, Restoril, and zaleplon (Sonata). However, if enough of this drug is used, it can produce a psychotropic effect. That result is enough to cause users to exceed their dosage to chase the said effect that a previous dose had.

Insomnia and hallucinations are listed as some of the rare prazosin side effects by the manufacturer. This drug could be associated with rare psychiatric adverse effects and sleep disturbances.
Insomnia and hallucinations are listed as some of the rare prazosin side effects by the manufacturer. This drug could be associated with rare psychiatric adverse effects and sleep disturbances.

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The high blood pressure drug prazosin is sometimes used to treat PTSD-related nightmares and insomnia that can increase suicide risk.

Prazosin Overdose Dangers. How Much Prazosin is Fatal?

Can you overdose on Prazosin? Yes. This prescription drug can overdose when too much is ingested, intentionally or accidentally. Considering that prazosin is not as potent or deadly as meth, prazosin overdose death is often the result of drug reactions. Prazosin reacts badly with drugs like avanafil, sildenafil, tadalafil, vardenafil, and verapamil. 

Common prazosin overdose symptoms include:

  • Dizziness
  • Drowsiness
  • Lightheadedness
  • Decreased reflexes
  • Fainting

Prazosin Interactions

Like any similar product on the market, it also carries a risk of adverse effects and drug interactions. Also, patients with hypotension and other medical issues must consult an expert before taking it. Most physicians also advise against alcohol while taking medications because it can hamper its effectiveness. Patients are tempted to take more pills when this happens, increasing their risk of overdosing. Although the addictive nature of prazosin is unknown, there are many other prescription drugs out there that are highly addictive. 

The high blood pressure drug prazosin is sometimes used to treat PTSD-related nightmares and insomnia that can increase suicide risk. But the study suggests the drug may worsen the side effects of prazosin for nightmares and may cause insomnia and not reduce suicidal thoughts in PTSD patients. We have to view this as not the final word, but it raises questions. The study included twenty PTSD patients, including two military veterans and several civilian women who had been sexually assaulted. All had active suicidal thoughts, some had previously attempted suicide, and most were taking antidepressants or had them prescribed for the study.

PTSD and Addiction Infographic

PTSD and drug addiction treatment is effective when sought from accredited dual diagnosis treatment centers. People who have experienced trauma can learn to feel comfortable in their surroundings and manage with stress. See PTSD treatment for information on the most effective PTSD medications and therapies.

Prazosin is a well-tolerated medication with a small but positive evidence base for treating PTSD-associated nightmares. However, this drug needs further trials and studies due to prazosin side effects, including prazosin withdrawal symptoms.
Prazosin is a well-tolerated medication with a small but positive evidence base for treating PTSD-associated nightmares. However, this drug needs further trials and studies due to prazosin side effects, including prazosin withdrawal symptoms.

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Prazosin Side Effects & Risks

  • Drowsiness or dizziness, a common prazosin side effect, may influence the person’s ability to operate or drive machinery, primarily within the first 24 hrs. when your prazosin dose is increased. You will also have adverse effects from lying down to standing, during hot weather, after physical exercise, or after drinking alcohol. You mustn’t drive or operate machinery until you know how this medication affects you.
  • Prazosin side effects may also include headache, weakness, lack of energy, nausea, and palpitations.
  • Prazosin may rarely cause syncope (temporary loss of consciousness or fainting), particularly when going from sitting to lying to standing. These occurrences may happen within 30 to 90 minutes of taking the drug. The risk of an episode is higher when prazosin is used simultaneously with another antihypertensive drug or during a dosage increase.
  • Sexual dysfunction is one of the uncommon prazosin side effects erectile dysfunction. Rarely, it may cause prolonged erections lasting more than four hours. Seek immediate medical help if these Prazosin side effects happen.
  • This drug may not be suitable for some people, including those with low blood pressure, pregnant or breastfeeding, or about to undergo eye surgery.
  • Effectiveness and safety in children have not been confirmed. More research is needed on prazosin side effects weight loss and prazosin side effects weight gain.
If someone is between the ages of 18 and 60, taking no other medication, or has no other medical conditions, the prazosin side effects and risks someone more likely to experience.
  • Prazosin may interact with other medications, which may cause adverse prazosin side effects, including lower blood pressure or cause dizziness.
  • Clinicians should be aware that there is a rare risk of priapism with prazosin, so, theoretically, there may be a greater than usual risk when combining trazodone and prazosin. Patients should be warned to pay attention to this possible Prazosin side effect.
  • Due to Prazosin side effects, Minipress (prazosin) lowers blood pressure but isn’t the first choice for treating high blood pressure (hypertension).
  • Not preferred for older people due to more chance of prazosin side effects urination and complications and prazosin side effects blood pressure
  • The safety of prazosin in pregnant mothers has not been established. Only use if the potential benefit warrants the risk. Use caution if this drug is used in a breastfeeding woman.

Prazosin Nightmares Side Effects

Nightmares, frequently associated with posttraumatic stress disorder and clinically relevant in today’s violent events, are challenging to treat, with few pharmacologic options. Extremely distressing and disturbing nightmares can have a profound negative effect on more than just an individual’s sleep; they also affect mental health, physical health, and quality of life.

These “repeated awakenings from the major sleep period or naps with detailed recall of extended and extremely frightening dreams, usually involving threats to survival, security, or self-esteem” are most frequently associated with posttraumatic stress disorder (PTSD) but can also be related to other conditions. They can contribute to alcohol and substance abuse, suicidal ideation, or completed suicide.

With an increasing number of veterans of military deployments reintegrating into civilian life, physicians can expect to see more patients with symptoms of PTSD, including nightmares and reduced sleep quality. Prazosin has been studied off-label for the treatment of trauma-associated nightmares. Given the difficulty of treating nightmares, prazosin can be a crucial pharmacologic treatment option. Further clinical trials are recommended to expand our knowledge about prazosin in different patient populations and what are the possible side effects it can cause.

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Prazosin and Alcohol Use Disorder Treatment

There are many explanations why someone can’t stop drinking, and one of them is alcohol withdrawal. Alcohol withdrawal symptoms include anxiety, negative mood, and cravings, and these symptoms lead someone to turn to alcohol once more. More severe symptoms of alcohol withdrawal range from hallucinations about 12 to 24 hours after that last drink to seizures within the first two days after the person stops drinking. That isn’t the same as delirium tremens or DTs, as you’ll likely hear them called. DTs usually start 48 to 72 hours after you put down the glass. These are severe symptoms that include vivid hallucinations and delusions. 

Study results revealed that the α-1 adrenergic receptor antagonist prazosin might reduce the likelihood of heavy drinking and the number of drinks each week over time but not the number of drinking days per week. Therefore, these findings indicated that prazosin as alcohol treatment shows potential as a harm-reduction pharmacologic approach to alcohol use disorder rather than a full-abstinence approach.

In human alcohol use disorder studies, prazosin has been shown to reduce reactivity to stress and to result in reduced cravings, reduced drinks per week, and reduced drinking days per week. According to study published by the National Center for Biotechnology (NCBI) [5], there may be a benefit to introducing prazosin during early drinking experiences. Prazosin slowed the acquisition of alcohol drinking and reduced the amount of alcohol consumed when administered before or concomitantly with the first opportunity to drink in rats genetically predisposed to high alcohol intake. 

Yale University [6] researchers report in the American Journal of Psychiatry has shown that brain stress centers are severely disrupted early in recovery, especially for those with withdrawal symptoms of alcohol drinking and drinking cravings. However, the disruption lessens the longer the person maintains their sobriety. Prazosin medication could help bridge that gap by moderating cravings and withdrawal symptoms earlier in recovery and increasing the chances that alcoholics refrain from drinking.

Risk Factors for Alcohol Use Disorder

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) [7], an estimated 15 million individuals in the United States have alcohol use disorder (AUD). A severe alcohol drinking problem. 14.4 million adults in the United States ages 18 and older have an AUD, including 9.2 million men and 5.3 million women. AUD is a chronic relapsing addiction previously called alcoholism. AUD is an inability to stop or control alcohol drinking despite adverse social, occupational, or health consequences.

Individuals must meet specific Diagnostic and Statistical Manual of Mental Disorders (DSM criteria) to be diagnosed with AUD. Using the DSM–5, anyone meeting two of the eleven criteria during the same 12-month period receives an AUD diagnosis. The severity of AUD—mild, moderate, or severe—is based on the number of criteria met.

Top 3 Prazosin Side Effects FAQs

  1. What are the side effects of prazosin?

    Alpha blockers such as prazosin may cause orthostatic hypotension (low blood pressure while standing after sitting or lying down), dizziness, fainting, quick loss of consciousness, palpitations (tachycardia), lightheadedness, and a lack of energy. Fainting or loss of consciousness may occur 30 to 90 minutes after administering the first dosage.

  2. Can you die from prazosin overdose?

    Yes. You mustn’t retake this drug if you’ve ever had an allergic reaction. Retaking it despite your adverse effects could be fatal (cause death). Alcohol interaction warning is included to cause prazosin overdose.

  3. Is it possible to have prazosin side effects nightmares?

    Prazosin is one possible treatment for PTSD nightmares. Physicians often prescribe it to treat high blood pressure, but it may also be used off-label (not FDA-approved) to treat PTSD nightmares. Nevertheless, prazosin can cause dizziness, headaches, sleepiness, weakness, heart palpitations, and nausea.

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Contact We Level Up NJ today for treatment resources and options if you or a loved one is struggling with prazosin side effects and withdrawal symptoms.
Contact We Level Up NJ today for treatment resources and options if you or a loved one is struggling with prazosin side effects and withdrawal symptoms.

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Prazosin drug may not be as fatal or as dangerous as other addictive drugs, but this drug is still capable of producing adverse prazosin side effects. The prescription pill detox process can be uncomfortable and difficult without medical assistance. However, getting through the detox process is crucial for continued treatment. We Level Up NJ provides proper care with round-the-clock medical staff to assist your recovery through our medically-assisted detox program. So, reclaim your life. Call us to speak with one of our treatment specialists. Our counselors know what you are going through and will answer any of your questions.

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[1] PrazosinU.S. Department of Health and Human Services National Institutes of Health

[2] Basquez R, Pippin MM. Prazosin. [Updated 2022 Jun 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from:


[4] Froehlich JC, Hausauer BJ, Federoff DL, Fischer SM, Rasmussen DD. Prazosin reduces alcohol drinking throughout prolonged treatment and blocks the initiation of drinking in rats selectively bred for high alcohol intake. Alcohol Clin Exp Res. 2013 Sep;37(9):1552-60. DOI: 10.1111/acer.12116. Epub 2013 Jun 3. PMID: 23731093; PMCID: PMC3775948.

[5] Understanding Alcohol Use Disorder – National Institute on Alcohol Abuse and Alcoholism (NIAAA)

[6-7] Justinova Z, Panlilio LV, Goldberg SR. Drug addiction. Curr Top Behav Neurosci. 2009;1:309-46. DOI: 10.1007/978-3-540-88955-7_13. PMID: 21104390; PMCID: PMC3039293

[8] McLellan AT. Substance Misuse and Substance Use Disorders: Why do they Matter in Healthcare? Trans Am Clin Climatol Assoc. 2017;128:112-130. PMID: 28790493; PMCID: PMC5525418.

[9] Justinova Z, Panlilio LV, Goldberg SR. Drug addiction. Curr Top Behav Neurosci. 2009;1:309-46. DOI: 10.1007/978-3-540-88955-7_13. PMID: 21104390; PMCID: PMC3039293.

[10] Jahan AR, Burgess DM. Substance Use Disorder. [Updated 2022 May 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: