Midodrine Side Effects

Brand Names: ProAmatine

Please note - some side effects for Midodrine may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

Side Effects of Midodrine - for the Consumer

Midodrine

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Midodrine:

Abnormal skin sensations or itching, especially of the scalp; chills; goosebumps; increased or frequent urination.

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; confusion or abnormal thinking; decreased urination; fainting; headache; increased or unusual dizziness; pounding in the ears or the chest; slow pulse; vision changes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

Midodrine Side Effects - for the Professional

Midodrine

The most frequent adverse reactions seen in controlled trials were supine and sitting hypertension; paresthesia and pruritus, mainly of the scalp; goosebumps; chills; urinary urge; urinary retention and urinary frequency.

The frequency of these events in a 3-week placebo-controlled trial is shown in the following table:

Less frequent adverse reactions were headache; feeling of pressure/fullness in the head; vasodilation/flushing face; confusion/thinking abnormality; dry mouth; nervousness/anxiety and rash. Other adverse reactions that occurred rarely were visual field defect; dizziness; skin hyperesthesia; insomnia; somnolence; erythema multiforme; canker sore; dry skin; dysuria; impaired urination; asthenia; backache; pyrosis; nausea; gastrointestinal distress; flatulence and leg cramps.

The most potentially serious adverse reaction associated with Midodrine hydrochloride therapy is supine hypertension. The feelings of paresthesia, pruritus, piloerection and chills are pilomotor reactions associated with the action of Midodrine on the alpha-adrenergic receptors of the hair follicles. Feelings of urinary urgency, retention and frequency are associated with the action of Midodrine on the alpha-receptors of the bladder neck.

Side Effects by Body System - for Healthcare Professionals

Cardiovascular

Marked elevation of supine arterial blood pressure is potentially the most serious side effect reported with midodrine therapy. The manufacturer reports a systolic pressure of 200 mmHg in 13.4% of patients receiving midodrine 10 mg orally. Patients with a mean pretreatment systolic pressure of 170 mmHg were more prone to this effect. There is no experience of midodrine administered to patients with a pretreatment systolic pressure over 180 mmHg.

The patient may be able to control supine hypertension by avoiding a full supine position.

Symptoms of supine hypertension may included, but are not limited to, cardiac awareness, pounding in the ears, headache, and blurred vision.

Cardiovascular side effects have frequently included supine and sitting hypertension.

Nervous system

Nervous system side effects have frequently included paresthesia (18.3%). Confusion, abnormal thinking, nervousness, and anxiety have also been reported. Dizziness, skin hyperesthesia, insomnia, and somnolence have been reported rarely.

Dermatologic

Scalp pruritus is the most common form of pruritus reported by patients.

Dermatologic side effects have frequently included piloerection (13.4%) and pruritus (12.2%). Rash has been reported in 2.4% of patients. Erythema multiforme and dry skin have been reported rarely.

Other

Other side effects have frequently included chills (4.9%) and pain/increase in level of pain (4.9%). Headache, feeling of pressure/fullness in the head, vasodilation/flushing of face, and dry mouth have also been reported. Leg cramps, canker sore, and backache have been reported rarely.

Genitourinary

Reports of dysuria have included urinary urge, urinary retention, urinary frequency, and impaired urination.

Genitourinary side effects have frequently included dysuria (13.4%).

Ocular

Ocular side effects have rarely included visual field defect.

Gastrointestinal

Gastrointestinal side effects have rarely included pyrosis, nausea, gastrointestinal distress, and flatulence.

Musculoskeletal

Musculoskeletal side effects have rarely included asthenia.

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