Wednesday, September 14, 2016

midodrine



Generic Name: midodrine (MY doe drin)

Brand names: ProAmatine, Orvaten


What is midodrine?

Midodrine is a vasopressor. Midodrine causes constriction (tightening) of the blood vessels which leads to an increase in blood pressure.


Midodrine is used to treat low blood pressure.


Midodrine may also be used for purposes other than those listed here.


What is the most important information I should know about midodrine?


In some cases, midodrine may cause an excessive increase in blood pressure, especially when lying down. Contact your doctor immediately or seek emergency medical attention if you experience an unusual awareness of heartbeats, pounding in the ears, headache, or blurred vision. These may be signs of increased blood pressure. In some cases, increased blood pressure may cause a slowed heart rate. Contact your doctor immediately or seek emergency medical attention if you experience decreased pulse rate, increased dizziness, fainting, or an unusual awareness of heartbeats. These may be signs of a slowed heart rate.

Midodrine can cause increased blood pressure when lying down. The last dose of midodrine should be taken at least 3 to 4 hours before bedtime. If you are going to be lying down for any length of time during the day, you may need to skip a dose of midodrine. Talk to your doctor about how to take midodrine if you lie down during the day.


Other prescription and over-the-counter medicines may cause an increase in blood pressure, which may be dangerous when taken with midodrine. Do not take any other prescription or over-the-counter medicines or herbal products especially cough, cold, or allergy products, weight loss products, asthma or respiratory medicines, migraine headache medicines, heart or blood pressure medicines, or antidepressants without first talking to your doctor.


What should I discuss with my healthcare provider before taking midodrine?


Do not take midodrine without first talking to your doctor if you have

  • heart or blood vessel problems (other than low blood pressure);




  • high blood pressure;



  • kidney problems;


  • difficulty urinating;




  • pheochromocytoma; or




  • over active thyroid.



Before taking this medication, tell your doctor if you have



  • liver problems;




  • visual disturbances;




  • diabetes; or




  • glaucoma.



You may not be able to take midodrine, or you may require a dosage adjustment or special monitoring during treatment.


Midodrine is in the FDA pregnancy category C. This means that it is not known whether it will be harmful to an unborn baby. Do not take midodrine without first talking to your doctor if you are pregnant or could become pregnant during treatment. It is not known whether midodrine passes into breast milk. Do not take midodrine without first talking to your doctor if you are breast-feeding a baby.

How should I take midodrine?


Take midodrine exactly as directed by your doctor. If you do not understand these instructions, ask your doctor, nurse, or pharmacist to explain them to you.


Take each dose with a full glass of water.

Midodrine can be taken with or without food.


Take midodrine at regular intervals as directed by your doctor.


Midodrine can cause increased blood pressure when lying down. The last dose of midodrine should be taken at least 3 to 4 hours before bedtime. If you are going to be lying down for any length of time during the day, you may need to skip a dose of midodrine. Talk to your doctor about how to take midodrine if you lie down during the day.


Your doctor may want you to have regular blood pressure monitoring or other medical evaluations during treatment with midodrine to monitor progress and side effects.


Store midodrine at room temperature away from moisture and heat.

See also: Midodrine dosage (in more detail)

What happens if I miss a dose?


Take the missed dose as soon as you remember then wait the prescribed amount of time before taking another dose. Generally, doses should not be taken less than 3 hours apart. Follow your doctor's instructions. Do not take a double dose of this medication, unless otherwise directed by your doctor.


What happens if I overdose?


Seek emergency medical attention if an overdose is suspected.

Symptoms of a midodrine overdose may include increased blood pressure (flushing, headache, pounding heartbeat, blurred vision), goosebumps, difficulty urination, a feeling of being cold, and loss of consciousness.


What should I avoid while taking midodrine?


Midodrine can cause increased blood pressure when lying down. The last dose of midodrine should be taken at least 3 to 4 hours before bedtime. If you are going to be lying down for any length of time during the day, you may need to skip a dose of midodrine. Talk to your doctor about how to take midodrine if you lie down during the day.


Other prescription and over-the-counter medicines may cause an increase in blood pressure, which may be dangerous when taken with midodrine. Do not take any other prescription or over-the-counter medicines or herbal products especially cough, cold, or allergy products, weight loss products, asthma or respiratory medicines, migraine headache medicines, heart or blood pressure medicines, or antidepressants without first talking to your doctor.


Midodrine side effects


In some cases, midodrine may cause an excessive increase in blood pressure, especially when lying down. Contact your doctor immediately or seek emergency medical attention if you experience an unusual awareness of heartbeats, pounding in the ears, headache, or blurred vision. These may be signs of increased blood pressure. In some cases, increased blood pressure may cause a slowed heart rate. Contact your doctor immediately or seek emergency medical attention if you experience decreased pulse rate, increased dizziness, fainting, or an unusual awareness of heartbeats. These may be signs of a slowed heart rate. If you experience any of the following serious side effects, stop taking midodrine and seek emergency medical attention or contact your doctor immediately:

  • an allergic reaction (shortness of breath; closing of the throat; hives; swelling of the lips, face, or tongue; rash; or fainting); or




  • irregular heartbeats, fluttering feeling in the chest, or chest pain.



Other, less serious side effects may be more likely to occur. Continue to take midodrine and talk to your doctor if you experience



  • chills or goosebumps;




  • itching or tingling of the skin;




  • increased need to urinate or difficulty with urination;




  • feeling of pressure or fullness in the head;




  • dryness of the mouth; or




  • nervousness or anxiety.



Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.


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?


Before taking midodrine, talk to your doctor if you are taking any other medicines especially any of the following:



  • an alpha adrenergic blocker such as alfuzosin (Uroxatral), doxazosin (Cardura), guanadrel (Hylorel), prazosin (Minipress), or terazosin (Hytrin);




  • flecainide (Tambocor);




  • cimetidine (Tagamet, Tagamet HB) or ranitidine (Zantac, Zantac 75);




  • digoxin (Lanoxin);




  • metformin (Glucophage);




  • fludrocortisone (Florinef);




  • triamterene (Dyrenium, Dyazide, Maxzide);




  • drugs that stimulate alpha-adrenergic receptors such as pseudoephedrine, phenylephrine, ephedrine, or dihydroergotamine;




  • quinidine (Quinaglute, Quinidex, Quin-Release); or




  • procainamide (Procan SR, Procanbid, Pronestyl).



You may not be able to take midodrine, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.


Other prescription and over-the-counter medicines may cause an increase in blood pressure, which may be dangerous when taken with midodrine. Do not take any other prescription or over-the-counter medicines or herbal products especially cough, cold, or allergy products, weight loss products, asthma or respiratory medicines, migraine headache medicines, heart or blood pressure medicines, irregular heartbeat medicines, or antidepressants without first talking to your doctor.


Drugs other than those listed here may also interact with midodrine. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.



More midodrine resources


  • Midodrine Side Effects (in more detail)
  • Midodrine Dosage
  • Midodrine Use in Pregnancy & Breastfeeding
  • Drug Images
  • Midodrine Drug Interactions
  • Midodrine Support Group
  • 10 Reviews for Midodrine - Add your own review/rating


  • midodrine Advanced Consumer (Micromedex) - Includes Dosage Information

  • Midodrine MedFacts Consumer Leaflet (Wolters Kluwer)

  • Midodrine Prescribing Information (FDA)

  • Midodrine Hydrochloride Monograph (AHFS DI)

  • ProAmatine Prescribing Information (FDA)



Compare midodrine with other medications


  • Dysautonomia
  • Hypotension
  • Postural Orthostatic Tachycardia Syndrome


Where can I get more information?


  • Your pharmacist has additional information about midodrine written for health professionals that you may read.

See also: midodrine side effects (in more detail)


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