Generic Name: midodrine (MY doe drin)
Brand Name: ProAmatine, Orvaten
What is midodrine?
Midodrine works by constricting (narrowing) the blood vessels and increasing blood pressure.
Midodrine is used to treat low blood pressure (hypotension) that causes severe dizziness or a light-headed feeling, like you might pass out. This medicine is for use only when low blood pressure affects daily life. Midodrine may not improve your ability to perform daily activities.
Midodrine may also be used for purposes not listed in this medication guide.
What is the most important information I should know about midodrine?
You should not use midodrine if you have severe heart disease, overactive thyroid, an adrenal gland tumor, kidney disease, if you are unable to urinate, or if your blood pressure is high even while lying down.
Midodrine can increase blood pressure even when you are at rest. This medicine should be used only if you have severely low blood pressure that affects your daily life. Midodrine may not improve your ability to perform daily activities.
What should I discuss with my healthcare provider before taking midodrine?
You should not use midodrine if you are allergic to it, or if you have:
severe heart disease;
kidney disease, or if you are unable to urinate;
pheochromocytoma (tumor of the adrenal gland);
overactive thyroid; or
high blood pressure even while lying down.
To make sure midodrine is safe for you, tell your doctor if you have:
glaucoma or a history of vision problems;
a history of kidney disease;
if you take a steroid medicine called fludrocortisone (Florinef); or
if you take drugs to treat high blood pressure or a prostate disorder, such as prazosin, terazosin, or doxazosin.
Your doctor may perform blood tests to make sure you do not have conditions that would prevent you from safely using midodrine.
FDA pregnancy category C. It is not known whether midodrine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine.
It is not known whether midodrine passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.
How should I take midodrine?
Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.
Midodrine is usually taken 3 times per day, with doses spaced at least 3 hours apart. Take your last dose of the day within 3 or 4 hours before bedtime.
You may take midodrine with or without food.
Take this medicine during your normal waking hours, when your are most likely to be upright and not lying down or napping. Ask your doctor about how to take this medicine if you normally lie down during the day.
Midodrine can increase your blood pressure even while you are lying down or sleeping (when blood pressure is usually lowest). Long-term high blood pressure (hypertension) can lead to serious medical problems.
Follow your doctor's instructions about the best way to position your body while you are laying down or sleeping. You may need to keep your head elevated to help prevent high blood pressure.
Your blood pressure will need to be checked before and during treatment with midodrine. Check your blood pressure while you are lying down, and check it again with your head elevated.
Midodrine is only part of a treatment program that may also include lifestyle changes, wearing support stockings on your legs, and possibly special medical care. Follow your doctor's instructions very closely.
Store at room temperature away from moisture and heat.
What happens if I miss a dose?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
You may need to skip a dose if you will be resting or lying down for a long period of time during your normal waking hours. Talk to your doctor about how to adjust your dose schedule if needed.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Symptoms of a midodrine overdose may include increased blood pressure (flushing, headache, pounding heartbeat, blurred vision), goosebumps, feeling cold, or trouble urinating.
What should I avoid while taking midodrine?
Avoid taking a dose within less than 3 hours before your normal bedtime.
Ask a doctor or pharmacist before using any over-the-counter diet pills, or cough/cold medicine that contains phenylephrine or pseudoephedrine.
Midodrine side effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Stop taking midodrine and call your doctor at once if you have:
severely slowed heart rate--weak pulse, severe dizziness or light-headed feeling; or
dangerously high blood pressure--severe headache, pounding sensation in your ears ("hearing" your heartbeats), blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure.
Common side effects may include:
numbness, tingling, or itching (especially in your scalp);
headache, dizziness, tired feeling;
increased urination, painful or difficult urination, or sudden urge to urinate.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
Midodrine dosing information
Usual Adult Dose for Hypotension:
Symptomatic orthostatic hypotension:
10 mg orally three times a day. Do not give more frequently than every 3 hours, after the evening meal, or less than 4 hours before bedtime.
Single doses of up to 20 mg orally have been administered to healthy adult patients. However, supine/sitting hypertension has been reported in up to 45% of patients with this dose, compared to 7.3% of patients receiving a dose of 10 mg orally.
Single doses of greater than 30 mg have been administered to healthy adult patients. However, the safety and efficacy of this dose has not been established.
What other drugs will affect midodrine?
Taking this medicine with other drugs that can constrict your blood vessels can further increase your blood pressure. Tell your doctor if you regularly use migraine headache medicine, asthma medicine, heart or blood pressure medicine, or an antidepressant.
Other drugs may interact with midodrine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.
More about midodrine
Related treatment guides
Where can I get more information?
- Your pharmacist can provide more information about midodrine.
- Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
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