Midodrine

Last Reviewed: Sep 10, 2024

Warnings

Midodrine Risks, Warnings, and Complications

Midodrine can cause or worsen health problems in certain people. Talk to your doctor or pharmacist about other treatment options if you are at a high risk of complications from this medication.

Supine Hypertension: Midodrine can cause markedly increased blood pressure when you are lying on your back (this is called supine hypertension). Systolic blood pressure (the top number) can rise to as high as 200 mmHg with a 10-mg dose of midodrine.
Before starting treatment with midodrine, tell your doctor if you have high blood pressure. Your doctor will check an initial supine and seated systolic blood pressure and also check it regularly during treatment. You should not take midodrine if your supine systolic blood pressure is above 180 mmHg.
Tell your doctor if you develop a pounding heartbeat, chest pain, headache, blurred vision, or pounding in the ears while on midodrine.
Drug Interactions: Taking midodrine with certain other medications can increase the risk of supine hypertension (high blood pressure). Tell your doctor or pharmacist if you take medications such as dihydroergotamine (DHE, Migranal), ephedrine, pseudoephedrine, phenylpropanolamine, and phenylephrine. You should know that many over-the-counter cold remedies and diet pills contain these drugs.
Stop taking midodrine and contact your doctor immediately if you develop a pounding heartbeat, headache, blurred vision, or pounding in the ears.

Precautions Before Starting Midodrine

Tell your doctor if you are allergic to midodrine, any of the active or inactive ingredients in midodrine tablets, or any other medications. Your pharmacy can give you a list of ingredients.

Give your doctor a complete list of your prescription medicines, over-the-counter medicines, vitamins, dietary supplements, and herbal products. This can help avoid possible drug interactions.

Give your healthcare provider a complete medical history. Midodrine may not be safe for people with certain medical conditions, such as urinary problems, vision problems, pheochromocytoma (a tumor of the adrenal glands), hyperthyroidism (overactive thyroid gland), diabetes, liver disease, heart disease, or kidney disease.

Midodrine may harm the unborn baby. Tell your doctor if you are pregnant, could be pregnant, are planning a pregnancy soon, or are breast-feeding.

Precautions During Use of Midodrine

Keep all your medical and laboratory appointments while taking midodrine. Your healthcare professional will want to check your sitting and supine blood pressure regularly while you are on this medicine.

Tell your doctor if you become pregnant while on midodrine.

Tell all your healthcare providers you are on midodrine, especially before any surgery or dental procedures.

Midodrine Drug Interactions

Concomitant use of midodrine with certain other drugs can affect how the medications work. Possible interactions between midodrine and other medicines can increase the risk of severe adverse effects. The following medications can interact with midodrine:

Dihydroergotamine (DHE, Migranal)
Ephedrine
Pseudoephedrine
Phenylpropanolamine
Phenylephrine
Alpha blockers such as terazosin, prazosin (Minipress), and doxazosin (Cardura)
Beta-blockers such as atenolol (Tenormin, in Tenoretic), carvedilol (Coreg), bisoprolol (Zebeta, in Ziac), labetalol (Trandate), metoprolol (Lopressor, Toprol XL), propranolol (Inderal, InnoPran XL), acebutolol (Sectral), nadolol (Corgard, in Corzide), betaxolol, pindolol, timolol, and sotalol (Betapace AF, Betapace, Sorine)
Monoamine oxidase inhibitors (MAOIs) such as linezolid, isocarboxazid, phenelzine, selegiline, and tranylcypromine
Tricyclic antidepressants such as amitriptyline, desipramine, imipramine, trimipramine, and nortriptyline
Medications prescribed for mental illnesses
Fludrocortisone
Digoxin (Lanoxin)

The above list may not describe all possible interactions of midodrine. Give your doctor or pharmacist a complete list of your medications, including prescription drugs, over-the-counter medications, dietary supplements, and herbal products. Also, tell your health care professional if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription medicines.

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