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What is midodrine?
ProAmatine is indicated for the treatment of symptomatic orthostatic hypotension (OH). Because ProAmatine can cause marked elevation of supine blood pressure (BP>200 mmHg systolic), it should be used in patients whose lives are considerably impaired despite standard clinical care, including non-pharmacologic treatment (such as support stockings), fluid expansion, and lifestyle alterations. The indication is based on ProAmatine’s effect on increases in 1-minute standing systolic blood pressure, a surrogate marker considered likely to correspond to a clinical benefit. At present, however, clinical benefits of ProAmatine, principally improved ability to perform life activities, have not been established. Further clinical trials are underway to verify and describe the clinical benefits of ProAmatine.
*This section republished from FDA prescribing information
What brand names are available for midodrine?
Is midodrine available as a generic drug?
Do I need a prescription for midodrine?
What are the side effects of midodrine?
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.
What is the dosage for midodrine?
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?
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.
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 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?
What preparations of midodrine are available?
Tablets: 2.5 mg, 5 mg, 10 mg
How should I keep midodrine stored?
Tablets should be stored at room temperature between 15 C to 30 C (59 F to 86 F).
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Midodrine (Orvaten, ProAmatine) is a medication prescribed to treat symptomatic orthostatic hyopotension (low blood pressure upon standing). Side effects, drug interactions, warnings, precautions, dosage, storage, and pregancy information should be reviewed prior to taking this medication.
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Related Disease Conditions
Low Blood Pressure (Hypotension)
Low blood pressure, also referred to as hypotension, is blood pressure that is so low that it causes symptoms or signs due to the low flow of blood through the arteries and veins. Some of the symptoms of low blood pressure include light-headedness, dizziness, and fainting if not enough blood is getting to the brain. Diseases and medications can also cause low blood pressure. When the flow of blood is too low to deliver enough oxygen and nutrients to vital organs such as the brain, heart, and kidneys; the organs do not function normally and may be permanently damaged.
Orthostatic hypotension symptoms include: LightheadednessWeaknessBlurred vision Syncope or passing out Causes of orthostatic hypotension include: Dehydration, Anemia, Medication Blood loss Low blood pressure Heat related illnesses Parkinson's disease Diabetes Treatment of orthostatic hypotension depends on the underlying cause.
POTS (POT Syndrome, Postural Orthostatic Tachycardia Syndrome)
POT syndrome (POTS, postrual orthostatic tachycardia syndrome) is a nervous system disorder that causes lightheadedness and fainting when a person stands up. Treatment may include increasing blood volume and regulating circulatory problems that are responsible for the disorder.
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Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
FDA Prescribing Information.