Do you feel dizzy or lightheaded when you suddenly stand up from a sitting position or when you get out of bed? Sometimes you feel like you're going to fall. In medical terms, this is called orthostatic hypotension. Simply put, it's a drop in blood pressure when you change your position. So, Midodrine is a drug that doctors often prescribe for people with these symptoms. Today, let's talk about this drug clearly and simply.
What exactly is Midodrine?
Simply put, Midodrine is a medication that lowers your blood pressure. When you stand up from a sitting position, gravity causes some blood to pool in your legs. This causes a slight decrease in blood flow to your brain, which can cause dizziness.
Midodrine works by tightening (constricting) the small blood vessels in your body. Just as squeezing a water pipe makes the water flow faster, tightening the blood vessels causes the blood to flow at a higher pressure. This helps to keep your blood pressure from suddenly dropping when you stand up. This medicine is available under the brand names Orvaten or ProAmatine.
Things you need to tell your doctor before starting this medication
Midodrine is not a one-size-fits-all medication. Therefore, it is extremely important that your doctor knows your complete medical history before prescribing this medication. Be sure to tell your doctor if you have any of the conditions listed below.
| Do you have this condition? | Why should you inform? |
|---|---|
| Heart disease | Because Midodrine can affect heart rate. |
| Pre-existing high blood pressure | Because this medicine can increase blood pressure even more. |
| Kidney disease | Because the kidneys remove medication from the body, the effects of the medication may change if the kidneys are not functioning properly. |
| Overactive thyroid | This condition can also increase blood pressure and heart rate. |
| Difficulty urinating | Midodrine can worsen this condition. |
| Pheochromocytoma | This is a tumor that occurs in the adrenal gland, and this medicine is not suitable because it can cause high blood pressure. |
| Being pregnant or trying to get pregnant | You should discuss the possible effects on the fetus with your doctor. |
| Breastfeeding | Consult your doctor about whether the medicine passes to your baby through breast milk. |
| Allergies to other medications, foods, or dyes | It can be dangerous if you are allergic to the medicine or its ingredients. |
The medicine should be used in the right way.
It is very important to follow your doctor's instructions exactly on how to use this medicine.
- Take this medicine with a glass of water.
- Most importantly: Do not take your last dose of medication of the day after dinner or within 4 hours of bedtime.
- Do not lie down for a long time after taking this medicine. This means do not do things like watch TV or read a book while reclining.
Why is that? When you are lying down, the action of Midodrine can cause your blood pressure to rise unnecessarily. This is called supine hypertension. Therefore, you should only take this medicine during the times of day when you are working, walking, or standing.
What to do if you miss a dose of medication?
If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Never take two doses at the same time.
What if I take too much medicine?
If you think you have taken too much medicine, immediately call the National Poisons Information Centre at the Colombo National Hospital . Or go to the Emergency Treatment Unit (ETU) of the nearest hospital.
This medicine is for you only. Never share your medicine with others.
Other medications that may interact with this medicine
Midodrine is a drug that can interact with other medications, so you should tell your doctor about all the medications you are taking (including vitamins and herbal remedies).
| Do not take Midodrine with this medicine. | |
|---|---|
| MAOIs (a class of drugs used to treat mental illness) | Ergot alkaloids (medicines used for migraines) |
| Some medicines for colds and breathing difficulties | Some medications for weight loss |
| If you are taking this medication, talk to your doctor. | |
| Digoxin, Flecainide (for heart disease) | Fludrocortisone (a hormonal drug) |
| Metformin (for diabetes) | Alpha-blockers (medicines for prostate disease and high blood pressure) |
| Cimetidine, Ranitidine (for gastritis) | Many more drugs... |
This list is not complete. Therefore , it is very important to tell your doctor about all the medications you take, and if you smoke or drink alcohol .
Things to be careful about when taking medicine
- Regular check-ups: See your doctor on scheduled dates to check your progress. He or she can check your blood pressure and decide if your medication dosage needs to be adjusted.
- Drowsiness and dizziness: This medication may make you feel drowsy and dizzy. Therefore, do not do anything that requires alertness, such as driving or operating machinery, until you know how the medication affects you.
- Don't get up too quickly: Don't stand up or sit down suddenly. Especially if you're elderly, change positions gradually. This will reduce the risk of dizziness and falls.
- Dry mouth: Your mouth may feel dry. Chewing sugar-free gum and drinking plenty of water can help.
- Taking medication for other illnesses: Do not take over-the-counter cough, cold, or pain medications without consulting your doctor. Some of these medications may increase your blood pressure.
What are the possible side effects of the medication?
Like any medication, Midodrine can cause side effects. Some of them are serious, some are not so serious.
| If you experience these symptoms, tell your doctor immediately. | |
|---|---|
| Severe headache, ringing in the ears | Fast, irregular heartbeat, or chest pain |
| Blurred vision | Skin rash, hives |
| If these symptoms persist or are bothersome, tell your doctor. | |
| Goose bumps | A tingling sensation in the scalp or skin |
| Itchy skin | Frequent need to urinate |
| Body coldness (Chills) | Stomach pain |
If you experience any other symptoms not mentioned on this list, talk to your doctor about them.
How should I store the medicine?
Storing medicine properly is also very important.
- Keep away from children.
- Store at room temperature (between 15-30 degrees Celsius). Protect from excessive heat and moisture.
- Throw away expired medicine.
Take-Home Message
- Midodrine is a medication used to control dizziness (orthostatic hypotension) that occurs when you stand up from a sitting position.
- The main and most important rule with this medicine is not to lie down for a long time after taking it. Take the last dose of the day at least 4 hours before bedtime.
- Tell your doctor about all other medications you take and any illnesses you have.
- If you experience symptoms such as severe headaches and chest pain, these may be signs of high blood pressure. If this happens, seek medical advice immediately.
- Always follow your doctor's instructions exactly. Do not stop taking your medication or change the dosage on your own.
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