Midodrine is a medication used to treat low blood pressure and belongs to the class of α-1 adrenergic receptor agonists. Its primary function is to constrict peripheral blood vessels, thereby increasing blood pressure to alleviate symptoms such as dizziness, lightheadedness, or fainting caused by chronic low blood pressure. This medication is typically used for conditions like autonomic dysregulation or orthostatic hypotension following surgery, but it should only be used after strict evaluation by a physician.
The treatment goal of Midodrine is to elevate standing blood pressure to a safe range, but it is important to note that its effects last only a few hours. Physicians will adjust the dosage based on the patient's age, medical history, and severity of symptoms, and will regularly monitor blood pressure changes. This medication is not suitable for treating high blood pressure and may interact with other antihypertensive medications.
The generic name of Midodrine is Midodrine, and the main brand names include:
Different countries or regions may have other product names, and patients should refer to the labeling on the medication packaging. Generic medications contain the same active ingredients as branded medications, but the dosage forms may vary slightly, so they should be used as directed by a physician.
Midodrine is classified as a peripheral α-1 adrenergic receptor agonist, with its primary mechanism of action being the selective stimulation of α-1 receptors in blood vessels, leading to peripheral vasoconstriction. Medications in this class are typically used to improve peripheral circulation issues, but due to their short duration of action, they need to be taken multiple times a day.
Unlike other vasopressors, the vasoconstrictive effects of Midodrine are more limited to the skin and peripheral blood vessels, having less impact on visceral blood vessels. Therefore, when treating orthostatic hypotension, it can minimize interference with visceral blood supply.
The main indications for Midodrine include:
This medication is usually prescribed for patients who do not respond well to other non-pharmacological treatments (such as increased salt intake or compression garments). In Taiwan, it can only be used with a physician's prescription.
It is not suitable for treating primary hypertension or acute hypotensive crises, and patients should not adjust the dosage on their own to avoid side effects.
Mild side effects include:
Severe side effects require immediate medical attention:
The following patients should avoid using Midodrine:
Pregnant or breastfeeding women should inform their physician as the effects on the fetus or infant have not been confirmed. For individuals over 65 years old, treatment should start at a lower dose to avoid excessive hypertension.
Combining Midodrine with the following medications may increase risks:
When taking diuretics or antihypertensive medications, the dosage of Midodrine may need to be adjusted. Avoid combining it with alcohol, as it may exacerbate dizziness or low blood pressure.
The common starting dose for adults is 2.5 mg, taken three times a day while awake. The maximum total daily dose should not exceed 30 mg. The tablets should be swallowed whole and not chewed or broken.
Dosing should be scheduled during daytime hours, as the effects last for 3-4 hours. It should not be taken before bedtime to avoid causing high blood pressure during the night or sleep disturbances.
If a dose is missed and it is more than 2 hours until the next scheduled dose, it should be taken immediately. If it is close to the time for the next dose, skip the missed dose and resume the normal dosing schedule. Never double up on doses to make up for a missed one.
If long-term missed doses lead to worsening symptoms, contact a physician immediately to adjust the medication plan and do not change the dosage on your own.
An overdose may lead to hypertensive crises, with symptoms including severe headaches, blurred vision, chest pain, or difficulty breathing. Seek immediate medical attention and bring the medication packaging for healthcare providers to assess.
Emergency measures may include continuous blood pressure monitoring, and in severe cases, antihypertensive medications may be used to alleviate symptoms. Patients should not attempt to manage this on their own and should go directly to the emergency room.
Midodrine raises blood pressure, and lying down shortly after taking it may lead to excessive blood flow to the head, causing headaches or dizziness. It is recommended to remain seated or standing for at least 15 to 30 minutes after taking the medication to reduce the risk of discomfort.
How can I relieve and manage dry mouth symptoms caused by Midodrine?Dry mouth is a common side effect and can be alleviated by chewing sugar-free gum or lozenges to stimulate saliva production, or by using artificial saliva products. If dry mouth significantly affects daily life, discuss dosage adjustments with your physician rather than stopping the medication on your own.
What interactions should I be aware of if I need to use other antihypertensive medications while taking Midodrine?Midodrine may have antagonistic effects with other blood pressure medications, reducing their efficacy. If it is necessary to combine it with beta-blockers or diuretics, the physician will adjust the dosage based on blood pressure monitoring results, and patients should proactively inform their physician of all medications they are currently taking.
What emergency measures should I take if my blood pressure is too high after taking Midodrine?If symptoms of high blood pressure occur, such as headaches or blurred vision, sit down or lower your head while sitting to avoid standing up suddenly. Measure your blood pressure immediately and record the values, and contact healthcare personnel promptly to assess whether medication adjustments are needed.
What health checks should long-term users of Midodrine undergo regularly?Long-term users are advised to monitor blood pressure fluctuations, kidney function, and electrocardiogram changes every 3 to 6 months. Physicians will adjust dosages based on blood pressure diaries and symptoms, and patients should avoid stopping the medication abruptly due to symptom improvement; instead, they should taper the dosage gradually to prevent rebound hypotension.
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