Midodrine for postural hypotension
Bramox
נבדק על ידי Sid Dajaniעודכן לאחרונה על ידי Michael Stewart, MRPharmSLast updated 15 Apr 2023
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Taking midodrine will raise your blood pressure to help stop you feeling dizzy or faint. To begin with you will need to be monitored closely to make sure your blood pressure doesn't go too high.
Do not take a dose of midodrine too late in the evening - your last dose of the day should be taken at least four hours before your bedtime.
While being treated with midodrine, try to keep your head raised slightly when lying down in bed, for instance by using extra pillows. This helps to reduce the risk of having high blood pressure when lying down.
At a glance
Midodrine is a medicine used to treat postural hypotension caused by a nervous system problem.
Postural hypotension is low blood pressure when standing, causing dizziness, light-headedness, or fainting.
Midodrine works by narrowing blood vessels, which increases blood pressure when standing.
Take midodrine exactly as prescribed by your doctor and do not take the last dose late in the evening.
Your blood pressure will be monitored, as it can go too high, especially when lying down.
Common side-effects include pain when passing urine, goosebumps, and itchy scalp.
Tell your doctor if you experience chest pain, a fast heartbeat, shortness of breath, headaches, or blurred vision.
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About midodrine
סוג התרופה | An alpha-adrenergic sympathomimetic medicine (alpha-agonist) |
שימוש עבור | Postural hypotension (low blood pressure when standing) due to autonomic nervous system dysfunction |
נקרא גם | Bramox® |
זמין כ | טבליות |
Midodrine is used to treat the problem of having low blood pressure when standing up from a sitting position or when already standing. This condition is known as postural hypotension, or alternatively, orthostatic hypotension. A drop in your blood pressure when you stand up can make you feel dizzy and light-headed, or cause you to faint. This can also put you at risk of falling over. Other symptoms include blurred vision, weakness or tiredness (fatigue), feeling sick (nausea) a fast heartbeat (palpitations) and headaches.
Postural hypotension can have a number of underlying causes. It may be caused by taking certain medicines or if you become lacking in fluid in the body (dehydrated) due to being sick (vomiting) or having diarrhoea. If this is the case, standing up slowly or sitting upright first before standing may help to manage your symptoms. Postural hypotension may also be caused by an underlying problem with your nervous system such as מחלת פרקינסון או נוירופתיה פריפרית.
Midodrine is used when severe symptoms are being caused by a problem with your nervous system and other forms of treatment have not helped. It works by stimulating certain parts of your nervous system (alpha receptors) which has the effect of narrowing your blood vessels. As your blood vessels narrow, your blood pressure goes up. This helps stop any dizziness or fainting when you stand up.
Before taking midodrine tablets
חזרה לתוכןSome medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking midodrine it is important that your doctor knows:
אם את בהריון, מנסה להיכנס להריון, או מניקה.
אם יש לך לחץ דם גבוה (יתר לחץ דם).
If you have been told you have a disorder of the nervous system.
If you have a heart condition or any problems with your blood vessels.
If you have any problems with your prostate gland or if you have difficulty passing urine.
If you have any problems with the way your kidneys or liver work.
If you have glaucoma, a condition which causes raised pressure in the eye(s).
If you have diabetes mellitus, a condition which raises your blood sugar levels. In particular, if your diabetes has caused any problems with your vision.
If you have an overactive thyroid gland (hyperthyroidism).
If you have a tumour on your adrenal gland, called phaeochromocytoma.
אם אי פעם הייתה לך תגובה אלרגית לתרופה.
אם אתה נוטל תרופות אחרות כלשהן. זה כולל כל תרופה שאתה נוטל שניתן לרכוש ללא מרשם, כמו גם תרופות צמחיות ומשלימות.
המשך לקרוא למטה
How to take midodrine tablets
חזרה לתוכןBefore you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The manufacturer's leaflet will give you more information about midodrine and a full list of side-effects which you may experience from taking it.
Take midodrine exactly as your doctor tells you to. Your dose will be written on the label of your pack to remind you.
The usual starting dose is one 2.5 mg tablet taken three times a day. Your blood pressure will need to be monitored and your dose may be increased each week until you find the lowest dose that controls your blood pressure. The maximum dose is 10 mg three times a day.
Swallow the tablets with a drink of water. It is not important whether you take your dose before or after food.
Do not take a dose of midodrine late in the evening, take your last dose of the day at least four hours before your bedtime.
If you forget to take a dose, take it as soon as you remember unless it is nearly time for your next dose or unless it is within four hours of your bedtime. In these cases leave out the forgotten dose and take your next dose when it is due. Do not take two doses together to make up for a forgotten dose.
להפיק את המרב מהטיפול שלך
חזרה לתוכןTry to keep all your regular appointments with your doctor. This is so your doctor can check on your progress.
Your blood pressure may need to be monitored when you are lying down and when you are standing up. This is to make sure your blood pressure does not go too high when you are lying down. If your blood pressure does go up when you are lying down then your dose of midodrine may need to be reduced.
You may find it useful to have a blood pressure meter to use at home. Ask your doctor or pharmacist for advice about testing your blood pressure at home.
When you are lying down in bed try to keep your head raised - for instance, by using extra pillows. This is to help prevent your blood pressure going too high when you are lying down.
If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking midodrine.
If you buy any medicines, check with your doctor or a pharmacist that they are suitable for you to take with midodrine.
המשך לקרוא למטה
Can midodrine tablets cause problems?
חזרה לתוכןAlong with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with midodrine. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
Very common midodrine side-effects (these affect more than 1 in 10 people) | מה אני יכול לעשות אם אני חווה את זה? |
Pain when passing urine | יידע את הרופא שלך על כך |
Goosebumps, itchy scalp | If either of these become troublesome, let your doctor know |
Common midodrine side-effects (these affect fewer than 1 in 10 people) | מה אני יכול לעשות אם אני חווה את זה? |
Feeling sick (nausea), indigestion or heartburn (reflux) | היצמדו לארוחות פשוטות - הימנעו ממזונות עשירים או חריפים |
Raised blood pressure when lying down | Using a blood pressure meter at home may help to identify this. Let your doctor know if you have any concerns |
כאב ראש | Let your doctor know if you experience repeated headaches, especially if you also have blurred vision (see below) |
קושי במתן שתן | יידע את הרופא שלך על כך |
Chills, tingling or itchy skin, skin flushing, skin rash, swollen or painful lining of the mouth | If any of these become troublesome let your doctor know |
חשוב: taking midodrine may cause your blood pressure to go too high. This can be a particular problem if it happens when you are lying down. Your dose may need to be reduced or your treatment stopped. Your doctor will monitor your blood pressure and it may also help to use a blood pressure meter at home.
Let your doctor know if you think your blood pressure is too high or if you experience symptoms such as:
כאב בחזה
A fast heartbeat (palpitations)
קוצר נשימה
Headaches
ראייה מטושטשת
אם אתה חווה תסמינים נוספים שלדעתך עשויים להיות כתוצאה מתרופה זו, פנה לרופא או לרוקח שלך.
How to store midodrine tablets
חזרה לתוכןשמור את כל התרופות מחוץ להישג ידם וראייתם של ילדים.
יש לאחסן במקום קריר ויבש, הרחק מחום ואור ישיר.
Midodrine tablets that are packaged in a bottle must be used within eight weeks of opening the bottle.
מידע חשוב על כל התרופות
חזרה לתוכןמידע חשוב על כל התרופות
לעולם אל תיקח יותר מהמינון שנקבע. אם אתה חושד שאתה או מישהו אחר אולי לקח מנת יתר של תרופה זו, פנה למחלקת תאונות וחירום בבית החולים המקומי שלך. קח את המיכל איתך, אפילו אם הוא ריק.
תרופה זו מיועדת עבורך. לעולם אל תיתן אותה לאנשים אחרים, גם אם מצבם נראה דומה לשלך.
אל תשמרו תרופות שפג תוקפן או שאינן רצויות. קחו אותן לבית המרקחת המקומי שלכם שיטפל בהן עבורכם.
אם יש לך שאלות לגבי התרופה הזו, שאל את הרוקח שלך.
דווח על תופעות לוואי לתרופה או חיסון
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שאלות נפוצות
What specifically is postural hypotension and how does midodrine help?
Postural hypotension, also known as orthostatic hypotension, is when your blood pressure drops significantly when you stand up from sitting or from a lying position. This can lead to symptoms like dizziness, light-headedness, blurred vision, weakness, nausea, a fast heartbeat, and headaches, potentially causing falls or fainting. Midodrine works by stimulating specific parts of your nervous system (alpha receptors) which causes your blood vessels to narrow. This narrowing increases your blood pressure, helping to prevent the feelings of dizziness or fainting when you stand up.
My postural hypotension is due to dehydration. Will midodrine help me?
If your postural hypotension is caused by dehydration, being sick, or diarrhoea, simple measures like standing up slowly or sitting upright before standing may help manage your symptoms. Midodrine is specifically used when severe symptoms of postural hypotension are caused by a problem with your nervous system, such as Parkinson's disease or peripheral neuropathy, and other treatments have not been effective.
How soon after starting midodrine can I expect to feel better?
When you start midodrine, your doctor will begin with a usual starting dose of one 2.5 mg tablet three times a day. Your blood pressure will be monitored closely, and your dose may be gradually increased each week until the lowest effective dose is found that controls your blood pressure. This process helps to determine how quickly you will start to feel better, as it depends on finding the right dose for your condition.
Can I adjust my midodrine dose if I feel like it's not working or if I experience side-effects?
You should always take midodrine exactly as your doctor tells you to. Your dose will be written on your pack. Do not adjust your dose yourself if you feel it's not working or if you experience side-effects. Your doctor will monitor your blood pressure and may adjust your dose as needed. If you have any concerns about the effectiveness or side-effects, it's important to discuss this with your doctor or pharmacist.
Why is it important to keep my head raised with extra pillows while in bed when taking midodrine?
It is important to keep your head raised, for example, by using extra pillows when you are lying down in bed. This helps to prevent your blood pressure from going too high while you are lying down, which can be a particular concern with midodrine. Your doctor will monitor your blood pressure both lying down and standing up to ensure it doesn't get too high and may adjust your dose if it does.
Are there any specific over-the-counter medicines or herbal remedies I should avoid while taking midodrine?
Before taking any other medicines, including those available without a prescription, as well as herbal and complementary medicines, you should always check with your doctor or a pharmacist to make sure they are suitable to take with midodrine. This is because some medicines may not be safe to combine with midodrine, or they could affect how well midodrine works.
I'm having dental work done soon. Do I need to tell my dentist about taking midodrine?
Yes, if you are having an operation or any dental treatment, it is important to tell the person carrying out the treatment that you are taking midodrine. This allows them to be aware of your medication and take it into account for your procedure.
קריאה נוספת והפניות
- Manufacturer's PIL, Bramox® 2.5 mg, 5 mg and 10 mg tablets; Brancaster Pharma Ltd, The electronic Medicines Compendium. Dated December 2021.
המשך לקרוא למטה
About the authorView full bio

מייקל סטיוארט, MRPharmS
Medicine Leaflet Review Manager – Contractor, Pharmacist
BPharm (Hons), MRPharmS
Michael is a community pharmacist practicing in the Midlands and South Yorkshire with more than 20 years’ experience advising on medicines and medical conditions. He has a strong background in healthcare training, having produced and delivered training courses for pharmacy teams and staff of residential care settings, including nurses. He has also contributed to pharmacy advisory boards for the management of low acuity conditions in the community.
About the reviewer

סיד דג'אני
Sultan Dajani qualified at the London School of Pharmacy in 1994 and became the youngest elected member of the Royal Pharmaceutical Society council since its founding in 1842.
היסטוריית המאמר
המידע בעמוד זה נכתב ונבדק על ידי קלינאים מוסמכים.
הסקירה הבאה מתוכננת ל: 13 אוקטובר 2027
15 Apr 2023 | הגרסה האחרונה
3 May 2017 | פורסם במקור
נכתב על ידי:
מייקל סטיוארט, MRPharmS

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