MIDODRINE
Background and Date of Approval
Midodrine is an antihypotensive agent approved for medical use in 1996.
Uses
It helps to treat orthostatic hypotension ( low blood pressure after sitting or lying down).
How is it administered?
The recommended starting dose of Midodrine tablet is 2.5 mg thrice daily with or without food. This dose can be increased weekly to 10 mg three times daily, which is the standard maintenance dose of 30 mg daily. Do not take this medication after the evening or less than three to four hours before bedtime.
Side Effects
The side effects known to occur commonly during the treatment with Midodrine are goosebumps, itching of the scalp and pain when urinating, headache, nausea, heartburn, rashes, chills, sweating, dyspepsia, flushing, intense heat feeling, urinary retention, palpitations, and chest pain. Notify your physician immediately if you have supine hypertension (increased blood pressure while lying down).
Warnings
Midodrine is not recommended for patients with high blood pressure, a slow pulse, trouble passing urine, or certain cardiovascular diseases. If you experience allergies to Midodrine and its ingredients, report to your doctor immediately. Inform your healthcare practitioner if you are diagnosed with a severe kidney problem. Your health care provider will regularly monitor kidney function and blood pressure during treatment. Avoid drinking alcohol since it may cause unpleasant side effects.
Precautions
Consult your doctor before using Midodrine drug if you are pregnant or plan to have a baby. Even though there are limited studies on humans, animal studies have shown harmful effects on the developing baby. Before prescribing them, your doctor will weigh the benefits and potential risks. Avoid breastfeeding your baby while on treatment with Midodrine as it passes into the breastmilk and harms the baby.
Word of Advice
Midodrine is contraindicated in children and adolescents below 18 years of age. Blood pressure monitoring is recommended throughout treatment; dose adjustment may be necessary based on readings. Administration in the evening is not recommended. Patients should refrain from driving or operating machinery if dizziness or lightheadedness occurs.
References
Goodman & Gilmanâs, The Pharmacological Basics of Therapeutics, Adrenergic agonists and antagonists, 12th edition, 2011,294-295. Brancaster Pharma Limited, Electronic medicines compendium (EMC), [ Revised on January 2021], [Accessed on 7th September 2022], https://www.medicines.org.uk/emc/files/pil.2265.pdf Shrine US Inc., US Food and Drug Administration, [ Revised on January 2017] [Accessed on 7th September 2022], https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/019815s010lbl.pdf
Frequently Asked Questions
What is Midodrine brand name?
Proamatine and orvaten are the brand names of Midodrine tablets and it belongs to the group of drugs known as alpha-adrenergic agonists.
What are the common side effects of Midodrine?
Midodrine side effects include goosebumps, itching of the scalp and pain when urinating, headache, nausea, heartburn, rashes, chills, sweating, dyspepsia, flushing, extreme heat, urine retention, palpitations, and chest pain.
Does Midodrine cause high blood pressure?
Midodrine might induce high blood pressure when lying down (supine hypertension). This medication should only be used by those with low blood pressure significantly interfering with their daily lives and those who have failed to respond to other treatments.
Is Midodrine drug a vasopressor?
Yes, Midodrine is a vasopressor and antihypotensive drug used to treat low blood pressure.
When should Midodrine not be given?
Midodrine must not be taken after the evening or less than three to four hours before bed because it raises blood pressure while lying down.
Can Midodrine lead to a stroke?
Midodrine can cause high blood pressure while lying down (supine hypertension). High supine blood pressure can result in strokes, heart attacks, heart failure, and kidney problems.
Does Midodrine start working right away?
Midodrine takes around an hour to start working. However, its act is short, but the impact lasts for two to three hours.