Adult: Initially, 2.5 mg 2-3 times daily, adjusted gradually according to response at weekly intervals, up to 10 mg tid. Last dose of the day should not be taken after evening meal or <4 hr before bedtime to reduce potential for supine HTN.
Renal Impairment
Initially, 2.5 mg 2-3 times daily, gradually increased as tolerated.
Description: Midodrine, a direct-acting sympathomimetic amine, is a prodrug which forms an active metabolite, desglymidodrine. It selectively activates the α1-adrenergic receptors of the arteriolar and venous vasculature, producing peripheral vasoconstriction and elevation of BP. Onset: Approx 1 hr. Duration: 2-3 hr. Pharmacokinetics: Absorption: Well absorbed from the GI tract. Bioavailability: 93% (desglymidodrine). Time to peak plasma concentration: 30 min (midodrine); 1-2 hr (desglymidodrine). Distribution: Poorly crosses the blood brain barrier. Plasma protein binding: <30%. Metabolism: Metabolised in the liver and other tissues. Undergoes rapid deglycination into its active metabolite, desglymidodrine. Excretion: Via urine (80% as desglymidodrine). Elimination half-life: 25 min (midodrine); approx 3-4 hr (desglymidodrine).
Chemical Structure
Midodrine Source: National Center for Biotechnology Information. PubChem Database. Midodrine, CID=4195, https://pubchem.ncbi.nlm.nih.gov/compound/Midodrine (accessed on Jan. 22, 2020)
Storage
Store between 20-25˚C. Protect from light and moisture.
C01CA17 - midodrine ; Belongs to the class of adrenergic and dopaminergic cardiac stimulants excluding glycosides. Used in the treatment of hypotension.
References
Anon. Midodrine . Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 21/07/2016.Buckingham R (ed). Midodrine Hydrochloride. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 21/07/2016.Douglas Pharmaceuticals Ltd. Gutron Tablets data sheet 03 February 2015. Medsafe. http://www.medsafe.govt.nz/. Accessed 21/07/2016.Joint Formulary Committee. Midodrine Hydrochloride. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com
. Accessed 21/07/2016.McEvoy GK, Snow EK, Miller J et al (eds). Midodrine Hydrochloride. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 21/07/2016.Midodrine Hydrochloride Tablet (Eon Labs, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 21/07/2016.