midodrine (Orvaten, ProAmatine)

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Charles Patrick Davis, MD, PhD
    Charles Patrick Davis, MD, PhD

    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

GENERIC NAME: midodrine hydrochloride

BRAND NAME: Orvaten, ProAmatine

DRUG CLASS AND MECHANISM: Midodrine (Orvaten or ProAmatine) is an oral agent that is used to treat symptomatic orthostatic hypotension (low blood pressure). After oral administration, midodrine is converted into its active metabolite, desglymidodrine. Desglymidodrine is an alpha-1 agonist and is responsible for the pharmacological benefits of treatment. Desglymidodrine exerts its actions through activation of the alpha-adrenergic receptors in the arteries and veins which causes constriction of blood vessels and subsequent increase in blood pressure. Administration of midodrine results in an increase in standing, sitting, and supine systolic (horizontal position) and diastolic blood pressure in patient with orthostatic hypotension. Standing systolic blood pressure is increased by approximately 15 to 30 mmHg 1 hour after administration of a 10 mg dose of midodrine. Midodrine was approved by the US Food and Drug Administration (FDA) on September 6 1996.



PREPARATIONS: Tablets: 2.5 mg, 5 mg, 10 mg

STORAGE: Tablets should be stored at room temperature between 15 C to 30 C (59 F to 86 F).

PRESCRIBED FOR: Midodrine is used for the treatment of symptomatic orthostatic hypotension. Midodrine should be reserved for patients who have failed standard clinical care, including life style modifications, fluid expansion, and non-pharmacological treatments.

DOSING: Orthostatic hypotension: The recommended dose is 2.5 to 10 mg 3 times daily during daytime hours while the patient is upright and participating in activities of daily living. The usual dose is 10 mg 3 times daily. A 4-hour interval should be observed shortly before or upon arising in the morning, midday, and late afternoon (no later than 6 PM). Midodrine should not be given more frequently than every 3 hours. The maximum daily dose is 40 mg. Midodrine should not be given after the evening meal or less than 4 hours before bedtime. Midodrine should only be continued in patients who respond during initial treatment.

Quick GuideLow Blood Pressure (Hypotension): Symptoms, Signs, Causes

Low Blood Pressure (Hypotension): Symptoms, Signs, Causes
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