Midodrine

Administration

• Type: Vasopressors, alpha-1 agonist
• Dosage Forms:
• Routes of Administration: PO
• Common Trade Names: ProAmatine, Orvaten

Adult Dosing

• 2.5-10mg PO q8h

Pediatric Dosing

Safety/efficacy not established

Special Populations

Pregnancy Rating

• Category C

Lactation risk

• Unknown if excreted in breastmilk

Renal Dosing

• Adult: 2.5mg PO q8h, increase as tolerated

Hepatic Dosing

• Adult: Use caution

Contraindications

• Allergy to class/drug
• Severe heart disease
• Supine hypertension
• Acute renal disease, urinary retention
• Pheochromocytoma
• Thyrotoxicosis
• Caution with:
  • Concomitant beta-blockers or digoxin (reflex bradycardia)
  • Concomitant use of drugs that increase BP (e.g. phenylephrine, levothyroxine, pseudoephedrine)
  • Concomitant MAOIs or linezolid
  • DM
  • Renal or hepatic impairment
  • Vision problems

Adverse Reactions

Serious

• Bradycardia
• Raised ICP

Common

• Paresthesias
• Piloerection, pruritus, rash, erythema multiforme, flushing
• Hypertension
• Urinary retention or urgency
• Abdominal pain, nausea, xerostomia
• Chills
• Anxiety, insomnia, somnolence, weakness
• Confusion, dizziness
• Headache
• Hyperesthesia

Pharmacology

• Half-life: 3-4h
• Metabolism: Enzymatic hydrolysis in systemic circulation
• Excretion: Renal

Mechanism of Action

• Selective alpha-1 adrenergic agonist

See Also

• Vasopressors