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Midodrine

Brand Name: ProAmatine, Orvaten

Generic Name: Midodrine

Drug Class: Alpha1 Agonists

What Is Midodrine and How Does It Work?

Midodrine is a vasopressor and antihypotensive drug used to treat low blood pressure.

Midodrine is available under the following different brand names: ProAmatine, and Orvaten.

Dosages of Midodrine

Dosage Forms and Strengths

Tablet

  • 2.5 mg
  • 5 mg
  • 10 mg

Dosage Considerations – Should be Given as Follows:

Symptomatic Orthostatic Hypotension

  • 2.5-10 mg orally every 8 hours
  • Usual dose: 10 mg orally every 8 hours
  • Doses greater than 30 mg/day have not been studied; should not exceed 40 mg/day

Stress Incontinence (Off-label)

  • 2.5-5 mg orally every 8-12 hours

Dosing Modifications

  • Renal impairment: 2.5 mg orally every 8 hours; increase as tolerated
  • Pediatric: Safety and efficacy not established

SLIDESHOW

Low Blood Pressure (Hypotension): Symptoms, Signs, Causes See Slideshow

What Are Side Effects Associated with Using Midodrine?

Common side effects of midodrine include:

Less common side effects of midodrine include:

Rare but serious side effects of midodrine include:

  • Slow heartbeat
  • Unusual feeling in the chest
  • Fainting
  • Confusion
  • Vision problems

This is not a complete list of side effects and other serious side effects may occur. Call your doctor for information and medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What Other Drugs Interact with Midodrine?

If your doctor has directed you to use this medication for your condition, your doctor or pharmacist may already be aware of any possible drug interactions or side effects and may be monitoring you for them. Do not start, stop, or change the dosage of this medicine or any medicine before getting further information from your doctor, healthcare provider or pharmacist first.

Severe interactions of midodrine include:

Midodrine has serious interactions with at least 32 different drugs.

Midodrine has moderate interactions with at least 180 different drugs.

Mild Interactions of midodrine include:

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

What Are Warnings and Precautions for Midodrine?

Warnings

May cause marked elevation of supine blood pressure; reserve use for patients whose lives are considerably impaired despite standard clinical care for orthostatic hypotension.

This medication contains midodrine. Do not take ProAmatine or Orvaten if you are allergic to midodrine or any ingredients contained in this drug.

Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

Contraindications

Effects of Drug Abuse

No information available

Short-Term Effects

  • See "What Are Side Effects Associated with Using Midodrine?"

Long-Term Effects

  • See "What Are Side Effects Associated with Using Midodrine?"

Cautions

  • May slow heart rate primarily due to vagal reflex; use caution when administering concomitantly with negative chronotropes, including digoxin, beta blockers, or other agents that decrease heart rate; discontinue use if signs or symptoms of slow heart rate (bradycardia) occur.
  • Risk of hypertension increases with concomitant administration of drugs that increase blood pressure (phenylephrine, pseudoephedrine, ephedrine, dihydroergotamine, thyroid hormones, or droxidopa); avoid concomitant use of drugs that increase blood pressure; if concomitant use cannot be avoided, monitor blood pressure closely.
  • Avoid concomitant administration with monoamine oxidase (MAO) inhibitors or linezolid.
  • It is essential to monitor supine and sitting blood pressures in patients receiving therapy; uncontrolled hypertension increases risk of cardiovascular events, particularly stroke.
  • Avoid concomitant use with treatment agents that may cause vasoconstriction.
  • Use caution in patients with diabetes mellitus, vision problems, and renal or hepatic impairment.
  • Take drug no later than 6 p.m.and 3-4 hours before bed to minimize supine hypertension.

Pregnancy and Lactation

  • Use midodrine with caution during pregnancy if benefits outweigh risks. Animal studies show risk and human studies are not available or neither animal nor human studies were done.
  • It is not known if midodrine is excreted into breast milk. Avoid use while breastfeeding.
References

Medscape. Midodrine.
https://reference.medscape.com/drug/proamatine-orvaten-midodrine-342442
RxList. Proamatine.
https://www.rxlist.com/proamatine-side-effects-drug-center.htm
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