This handout is for pheochromocytoma / paraganglioma. Your care team identified this based on: classic triad — paroxysmal headache + palpitations + diaphoresis (ada 2026).
Other reasons your team may use this plan: paroxysmal htn or resistant htn (ada 2026); adrenal incidentaloma >4 cm or imaging features (high hu, intense uptake) (ada 2026); family history men2 / vhl / nf1 / sdhx (ada 2026).
Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.
| Medication | Starting dose | How | When | What it does |
|---|---|---|---|---|
| phenoxybenzamine | 10 mg BID, titrate by 10–20 mg q2–3 d to BP <130/80 + mild postural | PO | BID for 10–14 d preop | Endocrine Society 2014 — irreversible α-blockade preferred |
| doxazosin | 1 mg → 8 mg | PO | daily, titrate | Selective α1 reversible — alternative; less reflex tachy (Endocrine Society 2014 pheo/PGL guideline) |
| prazosin | 1 mg TID, titrate | PO | TID | Alternative selective α1 (ADA 2026) |
| metoprolol_tartrate | 12.5–25 mg BID | PO | BID | β only after α; otherwise unopposed α → crisis (ADA 2026) |
| propranolol | 20 mg TID | PO | TID | Alternative non-selective; only AFTER α (ADA 2026) |
| amlodipine | 5–10 mg | PO | daily | Adjunct preop (ADA 2026) |
Plan: Preoperative α then β blockade (ADA 2026)
Contact your care team if any of the following happen:
Call 911 or go to the nearest emergency room right away if you have:
Endo + surgery + genetics; lifelong annual surveillance (ADA 2026)
Guideline: Endocrine Society 2014 Pheo/Paraganglioma Guideline (Lenders); ENS@T-PHEO; NANETS 2021