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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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.

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.

Medically Reviewed by a Doctor on 11/11/2014

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