Midodrine

By Medically reviewed by Panel Perubatan Hello Doktor

Generic Name: Midodrine Brand Name(s): Generics only. No brands available.

Uses

What is Midodrine used for?

This medication is used for certain patients who have symptoms of low blood pressure when standing. This condition is also known as orthostatic hypotension. Midodrine is used in people whose daily activities are severely affected by this condition, even after other treatments are used (e.g., support stockings). It is known as a sympathomimetic (alpha receptor agonist) that acts on the blood vessels to raise blood pressure.

How should I take Midodrine?

Take this medication by mouth with or without food as directed by your doctor, usually 3 times daily (at least 3 to 4 hours between doses). Follow all your doctor’s instructions carefully. This drug is taken during daytime hours, when people stand most often. This medicine should not be taken after the evening meal or less than 4 hours before bedtime. Taking your dose is not recommended if you plan to lie down for a long time afterward (e.g., taking a nap).

Dosage is based on your medical condition and response to treatment. Usually, your doctor will start you at a low dose and gradually increase your dose in order to reduce side effects. Do not increase your dose or take it more frequently than prescribed.

Use this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day.

Tell your doctor if your condition persists or worsens. This drug should be continued only in those people whose symptoms improve during treatment.

How do I store Midodrine?

Midodrine is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Midodrine in the bathroom or the freezer. There may be different brands of Midodrine that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Midodrine down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Midodrine?

Before taking midodrine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this drug, tell your doctor your entire medical history, including: high blood pressure, pheochromocytoma, overactive thyroid (hyperthyroidism), difficulty urinating (due to urinary retention or an enlarged prostate), heart disease, liver disease, kidney disease, diabetes.

Get up slowly to reduce dizziness when rising from a sitting or lying position.

This drug may rarely make you dizzy or drowsy or blur your vision. Alcohol or marijuana can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana.

Before having surgery, tell your doctor or dentist that you are taking this medication.

This medication is not recommended for use during pregnancy. It may harm an unborn baby. If you become pregnant or think you may be pregnant, tell your doctor right away. Consult your doctor for more details.

It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Midodrine during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Midodrine. Midodrine is pregnancy risk category C according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Midodrine?

Skin tingling, chills, “goose bumps,” stomach pain, or urinary problems (strong/frequent urge to urinate, frequent urination, trouble urinating) may occur. Less commonside effects include dry mouth, dizziness, drowsiness, trouble sleeping, or leg cramps. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

This medication can cause your blood pressure to increase, especially when you are lying down (supine hypertension). Stop taking midodrine and contact your doctor right away if you experience the following signs of supine hypertension: pounding heartbeat, pounding in the ears, headache, blurred vision.

Tell your doctor right away if you have any serious side effects, including: slow heartbeat, unusual feeling in the chest, fainting, pressure/fullness in the head, confusion, anxiety, weakness, vision problems.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Midodrine?

Some products have ingredients that could raise your blood pressure. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).

Midodrine may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Midodrine?

Midodrine may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Midodrine?

Midodrine may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Midodrine.

What is the dose of Midodrine for an adult?

Usual Adult Dose for Hypotension

10 mg orally 3 times a day during daytime hours when the patient needs to be upright

Comments:

-The three daily doses may be given at 3-hour intervals, if needed, but not more frequently.

-This drug should not be given after the evening meal or less than 4 hours before bedtime.

-This drug should only be continued in patients who appear to attain symptomatic improvement during initial treatment.

Use: Treatment of symptomatic orthostatic hypotension (OH) in patients whose lives are considerably impaired despite standard clinical care, including non-pharmacologic treatment such as support stockings, fluid expansion, and lifestyle alterations.

Renal Dose Adjustments

CrCl less than 90 mL/min: Initiate treatment using 2.5 mg doses

Acute renal disease: Contraindicated

Liver Dose Adjustments

Use with caution

Dialysis

This drug is dialyzable; however, no dose adjustment guidelines have been reported.

Other Comments

Monitoring:

-Cardiovascular: Supine, standing, and sitting blood pressure; signs or symptoms suggestive of bradycardia (e.g., pulse slowing, increased dizziness, syncope, cardiac awareness).

-Hepatic: Liver function prior to initial use and thereafter as needed.

-Renal: Kidney function prior to initial use and thereafter as needed.

Patient advice:

-Advise patients to immediately report supine hypertension symptoms (e.g., cardiac awareness, pounding in the ears, headache, blurred vision, etc.).

-Advise patients to discontinue this drug if supine hypertension persists.

-Inform patients to discontinue this drug if they experience any signs or symptoms suggestive of bradycardia (e.g., pulse slowing, increased dizziness, syncope, cardiac awareness).

-Advise patients to administer the final dose of the day 4 hours or more before bedtime to minimize nighttime supine hypertension. Nighttime supine hypertension may be further minimized by elevation of the patient’s head.

-Inform patients that certain components in over-the-counter products (e.g., cold remedies, diet aids) should be used cautiously with this drug as they can also increase blood pressure.

What is the dose of Midodrine for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Midodrine available?

Midodrine is available in the following dosage forms and strengths:

  • Oral tablet

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Midodrine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

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