Drug reference
Midodrine hydrochloride is a pro-drug of desglymidodrine. Desglymidodrine is a sympathomimetic agent, which acts on peripheral alpha-adrenergic receptors to increase arterial resistance, resulting in an increase in blood pressure.
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Severe orthostatic hypotension due to autonomic dysfunction when corrective factors have been ruled out and other forms of treatment are inadequate ▶BY MOUTH ▶Adult: Initially 2.5 mg 3 times a day, increased if necessary up to 10 mg 3 times a day, dose to be increased at weekly intervals, according to blood pressure measurements; usual maintenance 10 mg 3 times a day, avoid administration at night; the last daily dose should be taken at least 4 hours before bedtime
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Aortic aneurysm. blood vessel spasm. bradycardia. cardiac conduction disturbances. cerebrovascular occlusion. congestive heart failure. hypertension. hyperthyroidism. myocardial infarction. narrow-angle glaucoma. phaeochromocytoma. proliferative diabetic retinopathy. serious obliterative blood vessel disease. serious prostate disorder. urinary retention
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Atherosclerotic cardiovascular disease (especially with symptoms of intestinal angina or claudication of the legs). autonomic dysfunction. elderly (manufacturer recommends cautious dose titration). prostate disorders
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→Appendix 1: sympathomimetics, vasoconstrictor
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▶Common or very common Chills. flushing. gastrointestinal discomfort. headache. nausea. paraesthesia. piloerection . scalp pruritus. skin reactions. stomatitis. supine hypertension (dose-dependent). urinary disorders ▶Uncommon Anxiety. arrhythmias. irritability. sleep disorders ▶Rare or very rare Hepatic function abnormal. palpitations Cardiovascular system ▶Frequency not known Confusion. diarrhoea. vomiting SIDE-EFFECTS, FURTHER INFORMATION Manufacturer advises that treatment must be stopped if supine hypertension is not controlled by reducing the dose.
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Manufacturer recommends effective contraception during treatment in women of childbearing potential.
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Manufacturer advises avoid—toxicity in animal studies.
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Manufacturer advises avoid—no information available.
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Manufacturer advises avoid in severe or acute impairment.
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▶Manufacturer advises measure hepatic and renal function before treatment and at regular intervals during treatment. ▶Manufacturer advises regular monitoring of supine and standing blood pressure due to the risk of hypertension in the supine position.
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There can be variation in the licensing of different medicines containing the same drug. Tablet ▶Midodrine hydrochloride (Non-proprietary) Midodrine hydrochloride 2.5 mg Midodrine 2.5mg tablets | 100 tablet P £67.26 DT = £55.05 Midodrine hydrochloride 5 mg Midodrine 5mg tablets | 100 tablet P £94.98 DT = £75.05 ▶Bramox (Brancaster Pharma Ltd) Midodrine hydrochloride 2.5 mg Bramox 2.5mg tablets | 100 tablet P £55.05 DT = £55.05 Midodrine hydrochloride 5 mg Bramox 5mg tablets | 100 tablet P £75.05 DT = £75.05
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Manufacturer advises that patients report symptoms of supine hypertension (such as chest pain, palpitations, shortness of breath, headache and blurred vision) immediately. The risk of supine hypertension at night can be reduced by raising the head of the bed.
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Initially 2.5 mg 3 times a day, increased if
First-line fragment. Read the complete Indications and Dose section above.
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