Uses

Midodrine is indicated for the treatment of symptomatic orthostatic hypotension in patients whose daily functioning is considerably impaired despite standard non-pharmacological measures and fluid management.

Do not use if

Contraindicated in severe organic heart disease, acute renal disease, urinary retention, pheochromocytoma, thyrotoxicosis, and persistent supine hypertension.

Side effects

Common adverse effects include supine hypertension, paresthesia and scalp pruritus, piloerection (goosebumps), chills, urinary urgency, urinary retention, and urinary frequency.

Warnings

Midodrine can cause marked supine hypertension; instruct patients not to lie down for at least four hours after each dose. Blood pressure should be monitored regularly. Use in patients with renal impairment requires caution as the drug is renally excreted.

How it works

Midodrine is a prodrug converted to its active metabolite desglymidodrine, a selective alpha-1 adrenergic agonist. It increases arteriolar and venous tone, raising blood pressure without direct cardiac stimulation.

Storage

Store at controlled room temperature in a well-closed container, protected from light and moisture.