7 Midodrine Side Effects to Be Aware Of
Midodrine helps treat orthostatic hypotension. It works by narrowing blood vessels. Midodrine side effects include goose bumps and tingling skin. High blood pressure is also possible.
midodrine
Used for Hypotension
Used for Hypotension
Midodrine is used to treat adults with symptoms of orthostatic hypotension (low blood pressure when getting up after lying down or sitting). It's usually taken if things like compression stockings, drinking more fluids, and other lifestyle changes aren't enough to help. Midodrine works as an alpha-1 agonist to get blood pressure back up. The dose is taken by mouth three times a day. Take the last dose of the day a few hours before bedtime since it can raise your blood pressure too much if you lie down. Side effects include a tingling or prickling feeling and goosebumps. Midodrine is available as a generic.
What is Midodrine?
What is Midodrine used for?
- Symptomatic orthostatic hypotension
How Midodrine works
Midodrine belongs to the drug class called alpha-1 agonists. It works on proteins called alpha-1 receptors on your blood vessels. It squeezes your blood vessels and makes them more narrow. This helps raise your blood pressure.
When does Midodrine start working?Time passed since treatment started:
Drug facts
| Common Brands | Proamatine |
|---|---|
| Drug Class | Alpha-1 agonist |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | Lower-cost generic available |
| Availability | Prescription only |
Side effects of Midodrine
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Tingling or prickling feeling (18%)
- Goosebumps (13%)
- Discomfort while urinating (e.g., pain, trouble urinating; 13%)
- Itchy skin (12%)
- High blood pressure when lying down (7%)
- Chills (5%)
- Pain (5%)
- Rash (2%)
Less Common Side Effects
- Headache
- Feeling of pressure or fullness in the head
- Flushing in the face
- Confusion or not thinking clearly
- Dry mouth
- Nervousness
- Anxiety
Midodrine serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Very high blood pressure when lying down: changes in heartbeat, pounding in the ears, headache, blurry vision
- Very slow heart rate: slow pulse, more dizziness, fainting
When do Midodrine possible side effects begin and end?
Time passed since treatment started:
M
H
D
W
M
Tingling or prickling feeling
Goosebumps (chills)
Trouble urinating
Itchy skin
High blood pressure when lying down
Seek immediate medical care if you experience this side effect.
If a line continues to the right, you'll likely keep experiencing this side effect once it starts.
More on Midodrine side effects
The following Midodrine side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Blurred vision
cardiac awareness
headache
pounding in the ears
Rare
Fainting
increased dizziness
slow pulse
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Burning, itching, or prickling of the scalp
chills
goosebumps
urinary frequency, retention, or urgency
Less common
Anxiety or nervousness
confusion
flushing
headache or feeling of pressure in the head
skin rash
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Get your GoodRx coupon
$117.52
GoodRx discount
$20.63
Pros and cons of Midodrine
Pros
- One of the few FDA-approved medications for long-term orthostatic hypotension
- Raises blood pressure within an hour after taking
Cons
- Must take the medication when you'll be upright (i.e., not planning to lie down anytime soon)
- Need to take three times a day
Pharmacist tips for Midodrine
- You can take midodrine with or without food. Food doesn't affect how well the medication works.
- Take midodrine three times during the day when you know you'll need to sit and stand up. For example, you can take it once in the morning, then midday, and then late afternoon.
- Avoid taking midodrine if you plan to lie down for a while, such as before a nap. The medication can cause your blood pressure to get very high when you're lying down. This can sometimes be dangerous.
- It's best to take your last dose of midodrine for the day before dinner or at least 4 hours before bedtime. This medication can make your blood pressure get too high when you're lying down. When you avoid taking it too close to bedtime, it helps lower this risk as you sleep.
- Follow up with your prescriber about how well midodrine is helping your symptoms of orthostatic hypotension. This helps them decide if the medication is right for you. They can weigh the benefits with the risk of having very high blood pressure when lying down.
- Your prescriber might ask you to check and write down your blood pressure regularly while taking midodrine. Check it while you're lying down, sitting, and standing. Share these numbers with your care team. If your blood pressure is much higher when you're lying down or sitting than standing, your prescriber might tell you to stop taking this medication to keep you safe.
- Ask your prescriber if it's safe to take midodrine with over-the-counter cough and cold and pain medications. Some of these have ingredients that can raise blood pressure. Examples include phenylephrine and pseudoephedrine. Taking these with midodrine can raise your blood pressure too much, which can be harmful.
- Tell your prescriber if you take dihydroergotamine for headaches or stimulant medications like Adderall. These medications can raise your blood pressure. Taking them with midodrine can raise blood pressure even more, which can be dangerous.
- Tell your care team if you notice symptoms of very high blood pressure when lying down. These can include changes in your heartbeat, pounding in your ears, headache, or blurry vision. Stop taking midodrine as soon as possible and get medical help if these symptoms won't go away.
Risks and warnings for Midodrine
Midodrine can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Significant rise in blood pressure when lying down
- Risk factors: High blood pressure before taking a dose
Midodrine can cause very high blood pressure when you lie down. This can sometimes be serious. In studies, some people had very high blood pressure (above 200 mmHg) when they laid down after taking 10 mg of midodrine. Most times, these people had relatively high blood pressure to begin with. That's why you should tell your prescriber if you have high blood pressure. While taking midodrine, blood pressure can also go up while sitting.
Your prescriber will check your blood pressure while you're lying down and sitting during office visits. This helps make sure midodrine is still safe for you.
To minimize the risk of blood pressure rising too much, avoid taking midodrine when you plan to lie down for a while. For example, avoid taking it too close to bedtime.
Tell your care team if you have symptoms of very high blood pressure while lying down. Look out for changes in your heartbeat, pounding in the ears, headache, or blurry vision. Stop taking midodrine right away and get medical advice if these symptoms don't go away.
Slightly slower heart rate
- Risk factors: Taking digoxin (Lanoxin) | Taking beta blockers | Taking other medications that can slow heart rate
After taking midodrine, your heart rate might slow a little. Be careful if you take midodrine with medications that can slow heart rate. This can include digoxin (Lanoxin) and beta blockers. Signs of very slow heart rate include a slow pulse, dizziness, and fainting. If this happens, stop taking midodrine and let your care team know.
Midodrine dosage
The average cost for 90 tablets of 5mg of Midodrine is $24.02 with a free GoodRx coupon. This is 90.84% off the average retail price of $262.23. 
Tablet
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 10mg | 90 tablets | $26.77 | $0.30 |
| 5mg | 90 tablets | $24.02 | $0.27 |
| 2.5mg | 90 tablets | $20.63 | $0.23 |
Typical dosage for Midodrine
The typical dose is 10 mg by mouth three times a day.
Your dose might differ if you have kidney problems.
Interactions between Midodrine and other drugs
Midodrine may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Midodrine. Please note that only the generic name of each medication is listed below.
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Dihydroergotamine
- Tranylcypromine
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Deslanoside
- Digitoxin
- Droxidopa
- Ephedrine
- Furazolidone
- Iobenguane I 123
- Iobenguane I 131
- Iproniazid
- Isocarboxazid
- Levothyroxine
- Linezolid
- Liothyronine
- Methylene Blue
- Moclobemide
- Nialamide
- Phenelzine
- Phenylephrine
- Phenylpropanolamine
- Procarbazine
- Pseudoephedrine
- Rasagiline
- Safinamide
- Selegiline
- Thyroid
- Toloxatone
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
How much does Midodrine cost?
To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
Midodrine (generic)
$20.63
Midodrine contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Midodrine will not be safe for you to take.
- Severe heart conditions
- Sudden kidney problems
- Can't empty the bladder completely when urinating (urinary retention)
- Pheochromocytoma (a rare tumor in an adrenal gland tissue)
- Thyrotoxicosis (high levels of thyroid hormone)
- High blood pressure that occurs often when lying down
What are alternatives to Midodrine?
There are a number of medications that your doctor can prescribe in place of Midodrine. Compare a few possible alternatives below.
News about Midodrine
Midodrine images
