Midodrine Hydrochloride
A to Z Drug Facts
Midodrine Hydrochloride |
(mid-OH-drean HIGH-droe-KLOR-ide) |
ProAmatine |
Class: Vassopressor/antihypotensive agent |
Action Activates arteriolar and venous a-adrenergic receptors resulting in an increase in vascular tone and elevation of blood pressure.
Indications Treatment of symptomatic orthostatic hypotension in patients whose lives are considerably impaired despite standard clinical care, including support stockings, fluid expansion and lifestyle changes. Unlabeled use(s): Management of urinary incontinence.
Contraindications Severe organic heart disease, acute renal failure, urinary retention, phenochromocytoma, thyrotoxicosis or in patients with persistent and excessive supine hypertension.
ADULTS: PO 10 mg tid during daytime hrs. Renal function impairment: Start with 2.5 mg/dose.
Vasoconstrictors (eg, dihydroergotamine, ephedrine, phenylephrine, phenylpropanolamine, pseudoephedrine): May enhance pressor effects of midodrine. Alpha-blocking agents (eg, prazosin, terazosin, doxazosin): May antagonize pressor effects of midodrine. Cardiac glycosides: May precipitate bradycardia, AV block or arrhythmia. Fludrocortisone: May exacerbate supine hypertension.
Lab Test Interferences None well documented.
CV: Supine and sitting hypertension; bradycardia. CNS: Paresthesia; headache; confusion; nervousness; anxiety; confusion; abnormal thinking. DERM: Piloerection; scalp pruritis; rash. GI: Abdominal pain; dry mouth. GU: Dysuria (frequency, impaired micturation, urinary retention, urinary urgency). OTHER: Pain; chills; facial flushing; feeling of fullness/pressure in head.
Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy not established. Supine hypertension: Potentially most serious adverse reaction. Most common in patients with elevated pre-treatment supine systolic blood pressure (mean 170 mm/hg). Use is not recommended in patients with pre-treatment supine systolic blood pressure >180 mm/hg. Monitor supine and sitting blood pressures. Bradycardia: May occur due to vagal reflex. Use caution when coadministering with other agents that can reduce heart rate (eg, cardiac glycosides, b-blockers, psychopharmacologic agents). Urinary retention: Use with caution due to effect on a-adrenergic receptors of bladder neck. Renal function impairment: Use with caution. Initiate therapy with smaller doses. Hepatic function impairment: Use with caution. Diabetes: Use with caution.
PATIENT CARE CONSIDERATIONS |
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Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts