| Customization: | Available |
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| CAS No.: | 3092-17-9 |
| Formula: | C12h19cln2o4 |
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Midodrine hydrochloride is a synthetic prodrug that is metabolized into its active form, desglymidodrine, a selective α1-adrenergic receptor agonist. It works by stimulating peripheral α1-adrenergic receptors, leading to vasoconstriction and an increase in blood pressure. Unlike other vasopressors, midodrine is orally active and does not cross the blood-brain barrier significantly, reducing central nervous system side effects.
Midodrine is primarily used for the treatment of symptomatic orthostatic hypotension (low blood pressure upon standing) caused by:
Autonomic dysfunction (e.g., in Parkinson's disease, diabetic neuropathy, or multiple system atrophy).
Postural orthostatic tachycardia syndrome (POTS) in some cases.
Secondary hypotension due to medications or other conditions.
Standard adult dose: 2.5-10 mg orally, 2-3 times daily (last dose should be taken at least 4 hours before bedtime to avoid supine hypertension).
Dose adjustment: Required in renal impairment.
Onset of action: ~1 hour; duration of effect is ~2-4 hours.
Common:
Supine (lying down) hypertension (most significant risk).
Scalp tingling/paresthesia (due to vasoconstriction).
Goosebumps (piloerection), itching, urinary retention.
Serious but rare:
Severe bradycardia (slow heart rate).
Cardiac arrhythmias (in susceptible patients).
Severe hypertension (uncontrolled high blood pressure).
Acute kidney injury or severe renal impairment.
Pheochromocytoma (risk of hypertensive crisis).
Heart failure, arrhythmias, or severe cardiac disease.
Concurrent use with monoamine oxidase inhibitors (MAOIs).
Diuretics or antihypertensives: May counteract midodrine's effects.
Blood pressure monitoring (both standing and supine) is essential.
Avoid nighttime dosing to prevent nocturnal hypertension.
Use with caution in patients with urinary retention or glaucoma (due to α1-mediated smooth muscle contraction).
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