Midodrine
2 medicines
Midodrine is an alpha-adrenergic agonist that raises blood pressure in people with orthostatic hypotension, a drop in blood pressure on standing that causes dizziness or fainting. Its main risk is supine hypertension, a dangerous rise in blood pressure while lying down, so it should never be taken within a few hours of bedtime.
Key facts
- Midodrine (brand Gutron, also sold as ProAmatine) is an alpha-1 adrenergic agonist that narrows blood vessels to raise blood pressure.
- It's usually taken 3 times a day, during waking hours when you need to be upright, with doses spaced about 3 to 4 hours apart.
- Midodrine causes supine hypertension, a dangerous rise in blood pressure while lying down. Never take a dose within 4 hours of bedtime or before lying down, and sleep with your head and upper body raised.
- Seek urgent care for a severe headache, blurred vision, or chest pain, which can signal a dangerous blood pressure spike.
What midodrine treats
Midodrine treats symptomatic orthostatic (postural) hypotension, a fall in blood pressure on standing that causes dizziness, light-headedness or fainting, often due to a disorder of the autonomic nervous system. It's used when measures such as compression stockings and extra fluid and salt intake are not enough on their own.
How midodrine works
After you swallow a tablet, your body converts midodrine into an active form that stimulates alpha-1 receptors on blood vessel walls, causing them to narrow. This raises blood pressure and helps push blood back toward the brain when you stand, easing dizziness.
Before you take it
- Do not take midodrine if you have severe heart disease, acute kidney disease, urinary retention, a tumor called pheochromocytoma, or uncontrolled high blood pressure.
- Tell your prescriber about thyroid disease or diabetes affecting your nerves, since these can change how you respond to treatment.
- Other medicines that raise blood pressure, and drugs that slow the heart rate, can add to midodrine's effects.
- Your blood pressure should be checked lying down and standing during treatment, since your dose depends on both readings.
Side effects
Common effects include scalp tingling, goosebumps, and a chilled feeling on the skin.
Stop and seek urgent medical care for:
- A severe headache, blurred vision or confusion while lying down, which can signal supine hypertension.
- Chest pain or a pounding, irregular heartbeat.
- Difficulty urinating or a swollen bladder.
Safety essentials
- Take midodrine only during the day when you'll remain upright, and never within 4 hours of lying down for a nap or for the night, to avoid dangerous supine hypertension.
- Sit up with your head raised and check your blood pressure lying down periodically during treatment.
- Skip a dose rather than take it late if you plan to lie down soon afterward.
This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.