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Indoramin (trade name Baratol) is a piperidine antiadrenergic agent. its an alpha-1 selective adrenoceptor antagonist. Indoramin is a α-adrenoceptor antagonist which acts selectively and competitively on post-synaptic α1-adrenoceptors, causing a decrease in peripheral vascular resistance, relaxation of the bladder neck and contraction of the detrusor.1–3 In palliative care, indoramin is used for hesitancy of micturition associated with benign prostatic hypertrophy.4,5 Other selective α1-antagonists are available, namely prazosin, tamsulosin and terazosin.6 All may cause severe hypotension, particularly with the first dose and in patients receiving diuretics or other antihypertensive medication.7 Low cost is the only advantage in using prazosin; this has to be balanced against ease of compliance with tamsulosin and terazosin (o.d. compared to b.d.). Indoramin is probably the safest in debilitated patients.6 Muscarinic drugs and anticholinesterases are sometimes preferable to an α-adrenoceptor antagonist, e.g. bethanechol 10–25mg t.d.s., distigmine 5mg o.d. If necessary, one of these may be used concurrently with indoramin. Indoramin is also licensed for use in the management of hypertension
