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.

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What brand names are available for midodrine-oral?

Orvaten, ProAmatine

Is midodrine-oral available as a generic drug?

GENERIC AVAILABLE: Yes

Do I need a prescription for midodrine-oral?

Yes

What are the side effects of midodrine-oral?

The most common side effects of midodrine treatment are tingling, tickling, burning or prickling sensation, supine and sitting hypertension, numbness and itching which mainly affects the scalp area, goose bumps, chills, urinary urge, urinary retention, and urinary frequency.

Rare side effects associated with midodrine treatment are weakness, dry mouth, difficulty sleeping, anxiety, backache, canker sores, confusion, dizziness, dry skin, erythema, facial flushing, gas, upset stomach, heartburn, leg cramps, nausea, tiredness, and vision problems.

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

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

What is the dosage for midodrine-oral?

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.

Which drugs or supplements interact with midodrine-oral?

Midodrine may cause a decrease in the heart rate. Caution should be used when midodrine is given in other medications that may also reduce the heart rate such as cardiac glycosides, tricyclic antidepressants, beta blockers, and other agents.

Medications which have similar stimulatory effects on alpha-adrenergic receptors may enhance the pressor effects of midodrine. Examples of such medications include phenylephrine, pseudoephedrine, ephedrine, phenylpropanolamine, dihydroergotamine, and other agents that cause vasoconstriction.

Alpha-adrenergic blocking agents such as prazosin (Minipress), terazosin (Hytrin), and doxazosin (Cardura) may antagonize or cancel out the effects of midodrine therapy.

Midodrine may compete with drugs such as metformin (Glucophage), cimetidine (Tagamet), ranitidine (Zantac), procainamide (Pronestyl), triamterene (Dyrenium), flecainide (Tambocor), and quinidine for elimination by renal tubular secretion (clearance through the kidneys). Caution should be used if midodrine must be used with any of these agents.

Is midodrine-oral safe to take if I'm pregnant or breastfeeding?

It is not known if midodrine is excreted in breast milk. Due to the lack of safety data, midodrine should be used cautiously in nursing mothers.

What else should I know about midodrine-oral?

What preparations of midodrine-oral are available?

Tablets: 2.5 mg, 5 mg, 10 mg

How should I keep midodrine-oral stored?

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

REFERENCE: FDA Prescribing Information.

Last Editorial Review: 11/11/2014

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Reviewed on 11/11/2014
References
REFERENCE: FDA Prescribing Information.

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