midodrine (Orvaten, ProAmatine) (cont.)

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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.

DRUG INTERACTIONS: 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.

Medically Reviewed by a Doctor on 11/11/2014

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