Midodrine

Midodrine is used to treat low blood pressure (hypotension) that leads to severe dizziness or a light-headed feeling, which may make you feel like you might pass out. midodrine is only for use when low blood pressure impacts your daily life. Midodrine may not help you carry out daily activities.

Midodrine may also be used for reasons not mentioned in this medication guide.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Midodrine is usually taken 3 times per day, with doses spaced at least 3 hours apart. Take your last dose of the day before your evening meal or 4 hours before bedtime.

You may take midodrine with or without food.

Take midodrine during your normal waking hours, when you are most likely to be upright and not lying down or napping. Ask your doctor how to take this medicine if you normally lie down during the day.

Midodrine can increase your blood pressure even while you are lying down or sleeping (when blood pressure is usually lowest). Long-term high blood pressure (hypertension) can lead to serious medical problems.

Follow your doctor's instructions about the best way to position your body while you are lying down or sleeping. You may need to keep your head elevated to help prevent high blood pressure.

Your blood pressure will need to be checked before and during treatment with midodrine. Check your blood pressure while you are lying down, and check it again with your head elevated.

Your kidney and liver function may also need to be checked.

Midodrine is only part of a treatment program that may also include lifestyle changes, wearing support stockings on your legs, and possibly special medical care. Follow your doctor's instructions very carefully.

Store at room temperature away from moisture and heat.

You should not use midodrine if you have severe heart disease, overactive thyroid, an adrenal gland tumor, kidney disease, if you are unable to urinate, or if your blood pressure is high even while lying down.

Midodrine can increase blood pressure even when you are at rest. Midodrine should be used only if you have severely low blood pressure that affects your daily life. Midodrine may not improve your ability to perform daily activities.

You should not use midodrine if you are allergic to it, or if you have:

• severe heart disease;
• if you are unable to urinate;
• pheochromocytoma (tumor of the adrenal gland);
• overactive thyroid;
• high blood pressure (even while lying down); or
• kidney disease.

To make sure midodrine is safe for you, tell your doctor if you have or have ever had:

• diabetes;
• glaucoma or a history of vision problems; or
• liver disease.

It is not known if midodrine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Ask a doctor if it is safe to breastfeed while using this medicine.

Get emergency medical help if you have signs of an allergic reaction: hives, difficulty breathing, swelling of your face, lips, tongue, or throat.

Midodrine may cause serious side effects. Call your doctor right away if you have:

• a severely slowed heart rate—weak pulse, severe dizziness or light-headedness; or
• dangerously high blood pressure—severe headache, pounding sensation in your ears ("hearing" your heartbeats), blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure.

Common side effects of midodrine may include:

• increased blood pressure when sitting or lying down;
• chills, goosebumps;
• numbness, tingling, or itching (especially in your scalp); or
• increased urination, painful or difficult urination, or sudden urge to urinate.

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

Usual Adult Dose for Hypotension:

10 mg orally 3 times a day during daytime hours when the patient needs to be uprightComments:-The three daily doses may be given at 3-hour intervals, if needed, but not more frequently.-This drug should not be given after the evening meal or less than 4 hours before bedtime.-This drug should only be continued in patients who appear to attain symptomatic improvement during initial treatment.Use: Treatment of symptomatic orthostatic hypotension (OH) in patients whose lives are considerably impaired despite standard clinical care, including non-pharmacologic treatment such as support stockings, fluid expansion, and lifestyle alterations.

Take the medicine as soon as you remember, but skip the missed dose if it's almost time for your next dose. Do not take two doses at once.

You might need to skip a dose if you will be resting or lying down for a long time during your regular waking hours. Talk to your doctor about how to change your dose schedule if necessary.

Seek emergency medical help or call the Poison Help line at 1-800-222-1222.

Signs of an overdose include higher blood pressure (flushing, headache, fast heartbeat, blurred vision), goosebumps, feeling cold, or having trouble urinating.

Do not take a dose if it is less than 4 hours before bedtime.

Ask a doctor or pharmacist before using any over-the-counter diet or cough/cold medicine that contains phenylephrine or pseudoephedrine. These medicines may increase your blood pressure.

Taking midodrine with other medications that constrict blood vessels can raise your blood pressure even more. Inform your doctor about all the other medicines you are taking, especially:

• digoxin, digitalis, droxidopa, fludrocortisone;
• asthma medicine;
• phenylephrine, pseudoephedrine, ephedrine;
• heart or blood pressure medicine;
• migraine headache medicine;
• thyroid medicine;
• medications for high blood pressure or prostate issues--alfuzosin, doxazosin, prazosin, terazosin, silodosin, tamsulosin; or
• an MAO inhibitor--isocarboxazid, linezolid, methylene blue injection, phenelzine, tranylcypromine, and others.

This list is not complete. Other medications may affect midodrine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are included here.