Which symptom should be reported promptly when starting an alpha-1 blocker such as doxazosin?

• A. Dizziness or fainting
• B. Increased appetite
• C. Weight gain
• D. Frequent headaches

Answer: (A)

Starting an alpha-1 blocker like doxazosin can cause orthostatic hypotension, a drop in blood pressure when you stand up due to vasodilation of peripheral vessels. The symptom that should be reported promptly is dizziness or fainting, because it reflects a potentially dangerous blood pressure drop and a real risk for falls, especially in older adults. This effect is most common with the first dose, so clinicians often advise taking the initial dose at night and rising slowly from bed. Reporting dizziness or fainting early allows the provider to adjust the dose, change timing, or consider alternative therapy to prevent injury. Other symptoms such as increased appetite, weight gain, or headaches can occur with various medications but do not carry the same immediate safety risk from sudden blood pressure changes.