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Overview: Midodrine is commonly used to treat low blood pressure that causes symptoms, particularly low blood pressure upon standing (orthostatic hypotension). It helps treat low blood pressure by causing your blood vessels to constrict (narrow). Common side effects include tingling, itching, and high blood pressure. The main serious side effect is high blood pressure, particularly upon lying down.

Uses

What is midodrine used for?

Midodrine is commonly used to treat people that have low blood pressure upon standing (orthostatic hypotension) with symptoms that affect their daily life.

Midodrine may also be used for other conditions as determined by your healthcare provider.

How does midodrine work (mechanism of action)?

Midodrine helps treat low blood pressure by causing your blood vessels to constrict (narrow). 

How is midodrine supplied (dosage forms)?

Brands and other names

  • Orvaten
  • ProAmatine

Dosage forms and strengths

  • 2.5 mg oral tablets
  • 5 mg oral tablets
  • 10 mg oral tablets

How should I store midodrine?

Midodrine should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.

Side Effects

What are the most common side effects of midodrine?

The most common side effects of midodrine are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • High blood pressure (see below)
  • Numbness, tingling, or burning in your arms, feet, face, or scalp
  • Itching of the scalp
  • Chills
  • Inability to empty your bladder or an increased feeling of need to pee

There may be other side effects of midodrine that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of midodrine?

While less common, the most serious side effects of midodrine are described below, along with what to do if they happen.

High Blood Pressure (Hypertension). Midodrine may cause dangerous increases in your blood pressure, particularly when you are lying down. If you measure your blood pressure and the top number (systolic) is 180 mm Hg or higher or the bottom number (diastolic) is 120 mm Hg or higher, get medical attention right away. Increases in blood pressure may not be noticeable, but look out for and tell your healthcare provider right away if you have any of the following symptoms of severely high blood pressure.

  • Sudden severe headache
  • Chest pain
  • Dizziness or confusion
  • Trouble breathing
  • Nausea or vomiting
  • Blurry or other changes to vision
  • Anxiety
  • Buzzing in the ears
  • Nosebleed
  • Feeling of skipped heartbeats

Severe Allergic Reactions. Midodrine may cause allergic reactions, which can be serious. Stop taking midodrine and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Warnings & Precautions

Who should not use midodrine?

Allergies to Ingredients. People who are allergic to any of the following should not take midodrine.

  • Orvaten
  • ProAmatine
  • Midodrine
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific midodrine products they stock.

Heart Disease. People with heart disease should not take midodrine.

Kidney Problems. Midodrine should not be taken if your kidneys are not working as well as they should be. If there is a concern about the health of your kidneys, your healthcare provider may do tests to determine if they are working well enough to take this medicine.

Urinary Retention. People with an inability to empty their bladder should not take midodrine.

Pheochromocytoma. People with pheochromocytoma, a condition affecting the adrenal glands, should not take midodrine.

Thyrotoxicosis. People who have too much thyroid hormone in their body (thyrotoxicosis) should not take midodrine.

High Blood Pressure. People who have high blood pressure while lying down (supine hypertension) should not take midodrine.

What should I know about midodrine before using it?

Do not take midodrine unless it has been prescribed to you by a healthcare provider. Take it as prescribed.

Lying down after taking midodrine can raise your blood pressure. Take your last dose of the day three to four hours before bedtime to prevent high blood pressure while sleeping.

Do not share midodrine with other people, even if they have the same condition as you. It may harm them.

Keep midodrine out of the reach of children.

Many over-the-counter medicines, such as products used to treat cold symptoms, can raise blood pressure. Check with your healthcare provider before taking any over-the-counter medicine to help avoid any dangerous increase in blood pressure. 

Your healthcare provider will likely check your blood pressure, standing and lying down, before starting midodrine and while you are taking it. This is to watch for any dangerous increases in blood pressure. 

What should I tell my healthcare provider before using midodrine?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if midodrine is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

  • Heart disease
  • Kidney problems
  • Urinary problems
  • Adrenal gland problems
  • Thyroid problems
  • High blood pressure
  • Diabetes
  • Eye problems

Other Medicines and Supplements. Midodrine may interact with other medicines and supplements. Before taking midodrine, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how midodrine could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should take midodrine while you are pregnant or trying to get pregnant.

Breastfeeding. It is not known if midodrine passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take midodrine while breastfeeding.

Interactions

Does midodrine interact with foods or drinks?

There are no known interactions between midodrine and foods or drinks.

It is unknown if drinking alcohol will affect midodrine. The risk of dizziness may be increased if you drink alcohol while taking midodrine. 

Does midodrine interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking midodrine.

  • A decongestant that you spray in your nose or take by mouth, such as pseudoephedrine or phenylephrine, which is used to treat nasal congestion
  • An ergot, such as ergotamine (Ergomar) or dihydroergotamine (Migranal or Trudhesa), which is a medicine used to treat migraine
  • Digoxin (Lanoxin), which is a medicine used to treat irregular heartbeat and some types of heart failure
  • A monoamine oxidase inhibitor (MAOI), which is a medicine usually used for depression or Parkinson’s disease
  • A corticosteroid, such as fludrocortisone, dexamethasone, methylprednisolone, or prednisone, which is a medicine for certain inflammatory conditions
  • A beta-blocker, such as metoprolol (Lopressor, Toprol XL, and others), atenolol (Tenormin), or propranolol (Inderal LA, Innopran XL), which is a medicine that may be used for certain heart conditions or to lower blood pressure
  • A medicine for high blood pressure
  • A thyroid medicine, such as levothyroxine, which is used to raise thyroid hormone levels
  • Droxidopa, which is a medicine for low blood pressure
  • Linezolid (Zyvox), which is a medicine for bacterial infections
  • An alpha-blocker, such as terazosin, doxazosin, alfuzosin, or prazosin, which is a medicine that may be used for high blood pressure and/or difficulty peeing due to an enlarged prostate

This may not be a complete list of medicines that can interact with midodrine. Always check with your healthcare provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much midodrine?

If you or someone else has used too much midodrine, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of midodrine?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.