Midodrine

Midodrineis a vasopressor and antihypotensive drug used to treat low blood pressure.

• Midodrine is available under the following different brand names:ProAmatine, Orvaten。

Dosages of Midodrine:

Dosage Forms and Strengths

Tablet

• 2.5 mg
• 5 mg
• 10 mg

Dosage Considerations – Should be Given as Follows:

Symptomatic Orthostatic Hypotension

• 2.5-10 mg orally every 8 hours
• Usual dose: 10 mg orally every 8 hours
• Doses greater than 30 mg/day have not been studied; should not exceed 40 mg/day

StressIncontinence(Off-label)

• 2.5-5 mg orally every 8-12 hours

Dosing Modifications

• Renal impairment: 2.5 mg orally every 8 hours; increase as tolerated
• Pediatric: Safety and efficacy not established

Common side effects of midodrine include:

• Numbness and tingling
• "Goosebumps"
• Itching skin
• High blood pressurewhile lying down (supinehypertension)
• Urinary retention, urgency, frequency
• Chills
• Pain, including abdominal/stomach pain
• Rash
• Nervousness

Less common side effects of midodrine include:

• Anxiety
• Canker sore
• Confusion
• Dizziness
• Drowsiness
• Dry mouth
• Dry skin
• Erythema multiforme
• A feeling of pressure or fullness in the head
• Flushing, including facial flushing
• Headache
• Increased sensitivity of the skin
• 腿抽筋
• Nausea
• Trouble sleeping (insomnia)
• Weakness

Rare but serious side effects of midodrine include:

• Slow heartbeat
• Unusual feeling in the chest
• Fainting
• Confusion
• Vision problems

This is not a complete list of side effects and other serious side effects may occur. Call your doctor for information and medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

If your doctor has directed you to use this medication for your condition, your doctor or pharmacist may already be aware of any possible drug interactions or side effects and may be monitoring you for them. Do not start, stop, or change the dosage of this medicine or any medicine before getting further information from your doctor, healthcare provider, or pharmacist first.

• Severe interactions of midodrine include:
  • isocarboxazid
  • linezolid
  • phenelzine
  • selegilinetransdermal
  • tranylcypromine
• Midodrine has serious interactions with at least 32 different drugs.
• Midodrine has moderate interactions with at least 180 different drugs.
• Mild Interactions of midodrine include:
  • desmopressin
  • diltiazem
  • eucalyptus
  • hydrochlorothiazide
  • memantine
  • metformin
  • methyclothiazide
  • ofloxacin
  • quinine
  • ranitidine
  • sage
  • sulfamethoxazole
  • triamterene
  • trimethoprim
  • verapamil

本文档不包含所有可能的interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

Warnings

• May cause marked elevation of supine blood pressure; reserve use for patients whose lives are considerably impaired despite standard clinical care for orthostatichypotension.
• This medication contains midodrine. Do not take ProAmatine or Orvaten if you are allergic to midodrine or any ingredients contained in this drug.
• Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

Contraindications

• Severe organicheart disease, supine hypertension, acute renal disease, urinary retention, pheochromocytoma, thyrotoxicosis

Effects of Drug Abuse

No information available

Short-Term Effects

• See "What Are Side Effects Associated with Using Midodrine?"

Long-Term Effects

• See "What Are Side Effects Associated with Using Midodrine?"

Cautions

• May slow heart rate primarily due to vagal reflex; use caution when administering concomitantly with negative chronotropes, includingdigoxin, beta-blockers, or other agents that decrease heart rate; discontinue use if signs or symptoms of slow heart rate (bradycardia) occur.
• The risk of hypertension increases with concomitant administration of drugs that increase blood pressure (phenylephrine,pseudoephedrine,ephedrine, dihydroergotamine,thyroid hormones, or droxidopa); avoid concomitant use of drugs that increase blood pressure; if concomitant use cannot be avoided, monitor blood pressure closely.
• Avoid concomitant administration with monoamine oxidase (MAO) inhibitors or linezolid.
• It isessentialto monitor supine and sitting blood pressures in patients receiving therapy; uncontrolled hypertension increases the risk ofcardiovascularevents, particularlystroke.
• Avoid concomitant use with treatment agents that may causevasoconstriction.
• Use caution in patients with diabetes mellitus, vision problems, and renal or hepatic impairment.
• Take drug no later than 6 p.m.and 3-4 hours before bed to minimize supine hypertension.

Pregnancy and Lactation

• Use midodrine with caution during pregnancy if the benefits outweigh the risks. Animal studies show risk and human studies are not available or neither animal nor human studies were done.
• It is not known if midodrine is excreted into breast milk. Avoid use while breastfeeding.