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What is this medication?

Alpha1 Agonist

Midodrine is indicated for treatment of hypotension, symptomatic orthostatic.

Because midodrine can cause marked elevation of supine blood pressure, it should be used in patients whose lives are considerably impaired despite standard clinical care. The indication for use of midodrine in the treatment of symptomatic orthostatic hypotension is based primarily on a change in a surrogate marker of effectiveness, an increase in systolic blood pressure measured 1 minute after standing, a surrogate marker considered likely to correspond to a clinical benefit. At present, however, clinical benefits of midodrine, principally improved ability to carry out activities of daily living, have not been verified.

How does this medication work? 

Midodrine gets converted to an active metabolite, desglymidodrine, which is an alpha1-agonist. This agent increases arteriolar and venous tone resulting in a rise in standing, sitting, and supine systolic and diastolic blood pressure in patients with orthostatic hypotension.

How should I take this medication? 

Oral: Take 2.5-10mg 3 times daily during daytime hours when patient is upright.

How to Take: Doses may be given in approximately 3- to 4-hour intervals (e.g. shortly before or upon rising in the morning, at midday, in the late afternoon not later than 6 PM).

You Need to Avoid: Avoid administering <4 hours before bedtime to minimize risk of supine hypertension.

What should I watch for while using this medication? 

Before starting Midodrine, make sure your physician is aware of any allergies or medications you currently take, if you have diabetes, hepatic impairment, renal impairment, visual problems, pheochromocytoma, thyrotoxicosis, narrow angle glaucoma, are pregnant, or breastfeeding. Midodrine use has been associated with rare but serious adverse events such as bradycardia and supine hypertension.

What if I miss a dose?

If you miss a dose of medication, try to take it as soon as possible. However, if it is almost time for your next dose, take only that scheduled dose. Do not take double or extra doses.

How should I store this medication?

Keep out of the reach of children at all times. Store at room temperature, 59 to 86° F (15 to 30° C). Protect from light. Keep the container tightly closed. Properly dispose of any unused medication after the expiration date.

What are the possible side effects of using this medication?

Supine hypertension, paresthesia, piloerection, pruritis, dysuria, urinary retention, urinary urgency, polyuria.

Note this is not a complete list of side effects for Midodrine, only common ones.