Front Desk: 469-391-0070
Midodrine Uses, Dosage, and Side Effects for Low Blood Pressure
Summary of Key Points
Midodrine is a medication used to treat low blood pressure (hypotension) and related conditions. It works by constricting blood vessels, which helps raise blood pressure. Midodrine is often prescribed for conditions like orthostatic hypotension, where blood pressure drops upon standing. It’s essential to follow your doctor’s instructions closely when taking this medication. If you have any questions about your treatment, feel free to consult one of our telemedicine providers today.
Names of Medication
US Brand Name: ProAmatine
Generic Name: Midodrine
The generic name refers to the active ingredient in the medication, while the brand name is assigned by the manufacturer. In this article, the generic name will be shown in parentheses.
Pharmacologic Category
Alpha-1 Adrenergic Agonist
Midodrine Dosage
Midodrine is prescribed for various conditions related to low blood pressure. Always follow your doctor’s instructions and never adjust your dose without consulting them. If you need to speak with a healthcare provider, our telemedicine team is available to assist you.
Midodrine for Orthostatic Hypotension
Initial Dose: 2.5 mg to 10 mg taken orally three times a day.
Maintenance Dose: 10 mg three times a day, as tolerated.
Duration: Long-term treatment may be necessary depending on the condition.
Midodrine for Chronic Fatigue Syndrome
Initial Dose: 2.5 mg to 10 mg taken orally three times a day.
Maintenance Dose: 10 mg three times a day, as tolerated.
Duration: Treatment duration varies based on response and symptoms.
Midodrine for Neurogenic Orthostatic Hypotension
Initial Dose: 10 mg taken orally three times a day.
Maintenance Dose: 10 mg three times a day, adjusted based on response.
Duration: Long-term treatment may be required.
Midodrine for Postural Orthostatic Tachycardia Syndrome (POTS)
Initial Dose: 2.5 mg to 10 mg taken orally three times a day.
Maintenance Dose: 10 mg three times a day, as tolerated.
Duration: Treatment duration varies based on individual response.
Midodrine for Multiple System Atrophy
Initial Dose: 10 mg taken orally three times a day.
Maintenance Dose: 10 mg three times a day, adjusted based on response.
Duration: Long-term treatment may be required.
Midodrine for Diabetic Autonomic Neuropathy
Initial Dose: 2.5 mg to 10 mg taken orally three times a day.
Maintenance Dose: 10 mg three times a day, as tolerated.
Duration: Treatment duration varies based on response and symptoms.
Midodrine for Spinal Cord Injury
Initial Dose: 2.5 mg to 10 mg taken orally three times a day.
Maintenance Dose: 10 mg three times a day, as tolerated.
Duration: Treatment duration varies based on individual response.
Midodrine for Autonomic Failure
Initial Dose: 10 mg taken orally three times a day.
Maintenance Dose: 10 mg three times a day, adjusted based on response.
Duration: Long-term treatment may be required.
Midodrine for Vasovagal Syncope
Initial Dose: 2.5 mg to 10 mg taken orally three times a day.
Maintenance Dose: 10 mg three times a day, as tolerated.
Duration: Treatment duration varies based on response and symptoms.
Midodrine for Primary Orthostatic Hypotension
Initial Dose: 10 mg taken orally three times a day.
Maintenance Dose: 10 mg three times a day, adjusted based on response.
Duration: Long-term treatment may be required.
Dosage Forms and Strengths
Oral Tablets: 2.5 mg, 5 mg, 10 mg
Administration Instructions for Midodrine
Midodrine should be taken by mouth, typically three times a day. It’s important to take the medication during the day while you are upright and active. Avoid taking it within 4 hours of bedtime to prevent high blood pressure while lying down. Always follow your doctor’s instructions on how to take Midodrine, and if you have any questions, consult one of our telemedicine providers.
Contraindications for Midodrine
A contraindication is a specific situation or condition in which a medication should not be used because it may be harmful to the patient. If you have any of the following conditions, you should not take Midodrine. Always consult with your healthcare provider before starting or stopping any medication, and if you have any concerns, schedule a telemedicine appointment with one of our providers.
- Severe Heart Disease: Midodrine can raise blood pressure, which may worsen conditions like heart failure or coronary artery disease.
- Severe Kidney Disease: Midodrine is processed by the kidneys, and impaired kidney function can lead to dangerous levels of the drug building up in the body.
- Uncontrolled High Blood Pressure (Hypertension): Since Midodrine increases blood pressure, it can be dangerous for people with already high blood pressure.
- Urinary Retention: Midodrine may cause difficulty urinating, so it is not recommended for people who already have trouble emptying their bladder.
- Pheochromocytoma: This rare adrenal gland tumor can cause high blood pressure, and Midodrine may worsen the condition by further increasing blood pressure.
- Thyrotoxicosis: This condition involves an overactive thyroid, and Midodrine can exacerbate symptoms by raising blood pressure and heart rate.
Drug Interactions with Midodrine
Midodrine can interact with other medications, potentially leading to harmful effects. Be sure to inform your healthcare provider about all the medications you are currently taking, including over-the-counter drugs and supplements. Below are some medications that may interact with Midodrine:
- Fludrocortisone (Florinef): Often used to treat low blood pressure, combining it with Midodrine can cause dangerously high blood pressure.
- Monoamine Oxidase Inhibitors (MAOIs): Medications like phenelzine (Nardil) or tranylcypromine (Parnate) can increase the effects of Midodrine, leading to excessive increases in blood pressure.
- Beta-blockers: Drugs like propranolol (Inderal) or metoprolol (Lopressor) can interact with Midodrine by affecting heart rate and blood pressure control.
- Alpha-adrenergic blockers: Medications like prazosin (Minipress) or doxazosin (Cardura) may counteract the effects of Midodrine, making it less effective.
- Antihypertensive Medications: Drugs used to lower blood pressure, such as lisinopril (Zestril) or amlodipine (Norvasc), may interact with Midodrine by causing unpredictable changes in blood pressure.
Midodrine in Pregnancy
Is it safe to take Midodrine during pregnancy? The safety of Midodrine in pregnant women has not been thoroughly established. There is limited information on its effects on both the mother and the baby. If you are pregnant or planning to become pregnant, it’s essential to discuss the potential risks and benefits of taking Midodrine with your healthcare provider. They can help you evaluate the possible risks and determine the best course of action for both your health and your baby’s well-being.
Midodrine While Breastfeeding
Is it safe to take Midodrine while breastfeeding? There is currently insufficient data to determine whether Midodrine passes into breast milk or if it could affect a nursing infant. If you are breastfeeding, it’s important to consult your healthcare provider before starting Midodrine. They can help you weigh the benefits of the medication against any potential risks to your baby.
Estimated Cost of Midodrine Medication
The estimated cost for a 30-day supply of Midodrine (2.5 mg or 5 mg tablets, taken three times daily) without insurance ranges from approximately $20 to $40 with a GoodRx coupon. Prices may vary depending on the pharmacy and your location, so it’s a good idea to check with your local pharmacy or use a prescription savings tool like GoodRx to find the best price.
Possible Alternatives to Midodrine
If Midodrine is not suitable for you, there are alternative treatments and lifestyle modifications that may help manage your condition. Always discuss these options with your healthcare provider before making any changes to your treatment plan. You can also schedule a telemedicine appointment with one of our providers to explore these alternatives.
Orthostatic Hypotension
Alternatives include medications like fludrocortisone (Florinef) or droxidopa (Northera). Lifestyle adjustments, such as increasing fluid and salt intake, wearing compression stockings, and avoiding sudden changes in position, may also be beneficial.
Chronic Fatigue Syndrome
There is no specific medication for chronic fatigue syndrome, but treatments may include graded exercise therapy, cognitive behavioral therapy, and medications to manage symptoms like pain or sleep disturbances.
Neurogenic Orthostatic Hypotension
In addition to Midodrine, other treatments such as droxidopa (Northera) or non-pharmacological approaches like physical counter-maneuvers and increased salt intake may be considered.
Postural Orthostatic Tachycardia Syndrome (POTS)
Treatment options include beta-blockers like propranolol (Inderal), ivabradine (Corlanor), or lifestyle changes such as increasing fluid intake, using compression stockings, and engaging in physical therapy.
Multiple System Atrophy
Treatment focuses on managing symptoms, which may include medications like fludrocortisone (Florinef) or droxidopa (Northera), along with lifestyle changes such as elevating the head of the bed and increasing fluid intake.
Diabetic Autonomic Neuropathy
Managing blood sugar levels is crucial. Medications like fludrocortisone (Florinef) or pyridostigmine (Mestinon) may help alleviate symptoms of low blood pressure.
Spinal Cord Injury
Treatment may involve medications like fludrocortisone (Florinef) or non-pharmacological approaches such as physical therapy and the use of compression garments.
Autonomic Failure
In addition to Midodrine, other treatments like fludrocortisone (Florinef) or droxidopa (Northera) may be considered. Lifestyle changes, such as increasing fluid and salt intake, can also be helpful.
Vasovagal Syncope
Treatment options include beta-blockers like metoprolol (Lopressor) or lifestyle changes such as avoiding triggers, staying hydrated, and using physical counter-maneuvers.
Primary Orthostatic Hypotension
Besides Midodrine, fludrocortisone (Florinef) and non-pharmacological treatments like increasing salt and fluid intake may help manage symptoms.
Recent Updates on Midodrine Research
Recent studies have focused on the long-term safety and effectiveness of Midodrine for treating conditions like orthostatic hypotension. A 2022 study published in the journal Clinical Autonomic Research found that Midodrine remains an effective treatment for neurogenic orthostatic hypotension, with sustained benefits over time. However, researchers emphasize the importance of regularly monitoring blood pressure due to the risk of supine hypertension (high blood pressure while lying down).
Ongoing clinical trials are also exploring the use of Midodrine in combination with other medications to improve outcomes for patients with autonomic disorders. These studies aim to refine dosing strategies and minimize side effects. As always, consult your healthcare provider for the latest information on Midodrine and whether it is the right treatment for you. If you have questions, you can schedule a telemedicine appointment with one of our providers to discuss your options.
