9
Table 5. Medications With Minimal Effects on Plasma
Aldosterone Levels That Can Control Hypertension
During Case Finding and Confirmatory Testing for PA
Drug Class Usual Dose Comments
Verapamil
slow- release
Non-
dihydropyridine
slow-release
antagonist calcium
channel
90–120 mg twice
daily
Use singly or in
combination with the
other agents listed in
this table
Hydralazine Vasodilator 10–12.5 mg twice
daily, increasing as
required
Commence verapamil
slow-release first
to prevent reflex
tachycardia.
Commencement at
low doses reduces
risk of side effects
(including headaches,
flushing, and
palpitations)
Prazosin
hydrochloride
α-Adrenergic
blocker
0.5–1 mg two or
three times daily,
increasing as
required
Monitor for postural
hypotension
Doxazosin
mesylate
α-Adrenergic
blocker
1–2 mg once
daily, increasing as
required
Monitor for postural
hypotension
Terazosin
hydrochloride
α-Adrenergic
blocker
1–2 mg once
daily, increasing as
required
Monitor for postural
hypotension
Adapted from J. W. Funder et al: Case detection, diagnosis, and treatment of patients with primary
aldosteronism: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab.
2008;93:3266 –3281, with permission. © Endocrine Society.
