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All about: Midodrine

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Generic Name: Midodrine (MIH-doe-DREEN)
Brand Name: Orvaten and ProAmatine

Midodrine may cause a significant increase in blood pressure when lying down. It should be used only in patients whose lives are significantly affected even after using standard treatments. Your blood pressure will be monitored carefully during treatment. Benefits of Midodrine have not been confirmed.


Midodrine is used for:

Treating dizziness that occurs upon sitting up or standing (orthostatic hypotension).

Midodrine is an alpha-agonist. It works by causing blood vessels to constrict (become smaller), which helps to increase blood pressure.

Do NOT use Midodrine if:

  • you are allergic to any ingredient in Midodrine
  • you have severe heart disease, active kidney disease, an adrenal gland tumor (pheochromocytoma), or high thyroid hormone blood levels (thyrotoxicosis), or you are unable to urinate
  • you have persistent or severe high blood pressure while lying down

Contact your doctor or health care provider right away if any of these apply to you.

Before using Midodrine :

Some medical conditions may interact with Midodrine . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have diabetes; high blood pressure; difficulty urinating; liver, kidney, heart, or vision problems; or an overactive thyroid

Some MEDICINES MAY INTERACT with Midodrine . Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Alpha-blockers (eg, prazosin) because the effectiveness of Midodrine may be decreased
  • Antiarrhythmics (eg, flecainide, procainamide, quinidine), antipsychotics (eg, aripiprazole), beta-blockers (eg, propranolol), cardiac glycosides (eg, digoxin), cimetidine, ergotamine derivatives (eg, dihydroergotamine), fludrocortisone, metformin, ranitidine, sympathomimetics (eg, ephedrine, phenylephrine, pseudoephedrine), or triamterene because the risk of side effects may be increased

This may not be a complete list of all interactions that may occur. Ask your health care provider if Midodrine may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Midodrine :

Use Midodrine as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Midodrine may be taken with or without food.
  • Midodrine should be taken during the day when you need to be in an upright position and pursuing activities of daily life. Follow the dosing schedule provided by your doctor carefully.
  • Do not take Midodrine after your evening meal or less than 4 hours before bedtime, unless otherwise directed by your doctor.
  • If you miss a dose of Midodrine , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Midodrine .

Important safety information:

  • Midodrine may cause drowsiness, dizziness, or fainting. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Midodrine . Using Midodrine alone, with certain other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks.
  • Measure your blood pressure regularly according to your doctor's directions.
  • Avoid using nonprescription medicines that contain stimulants, such as products for dieting (appetite suppressants) or cold symptoms (eg, pseudoephedrine) while you are using Midodrine .
  • LAB TESTS, including kidney and liver function and blood pressure, may be performed to monitor your progress or to check for side effects. Be sure to keep all doctor and lab appointments.
  • Use Midodrine with extreme caution in CHILDREN. Safety and effectiveness have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: If you become pregnant, discuss with your doctor the benefits and risks of using Midodrine during pregnancy. It is unknown if Midodrine is excreted in breast milk. If you are or will be breast-feeding while you are using Midodrine , check with your doctor or pharmacist to discuss the risks to your baby.

Possible side effects of 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:

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

Seek medical attention right away if any of these SEVERE side effects occur:

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 or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org/findyour.htm), or emergency room immediately. Symptoms may include feeling cold; inability to urinate; severe or persistent dizziness or headache; slow heartbeat.

Proper storage of Midodrine :

Store Midodrine between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Midodrine out of the reach of children and away from pets.

General information:

  • If you have any questions about Midodrine , please talk with your doctor, pharmacist, or other health care provider.
  • Midodrine is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Midodrine . If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: September 5, 2007
Database Edition 07.3.1.003
Copyright © 2007 Wolters Kluwer Health, Inc.

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