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Midodrine. A review of its pharmacological properties and therapeutic use in orthostatic hypotension and secondary hypotensive disorders.
Drugs. 1989 Nov; 38(5):757-77.D

Abstract

Midodrine, a peripheral alpha-adrenergic agonist, finds use in the clinical management of patients with orthostatic hypotension or hypotension secondary to other clinical conditions or drug therapies. Midodrine is almost completely absorbed after oral administration and undergoes enzymatic hydrolysis to form its pharmacologically active metabolite, de-glymidodrine. In patients with refractory orthostatic hypotension oral midodrine increases standing blood pressure and improves symptoms of orthostatism, such as weakness, syncope, blurred vision and fatigue, without any associated cardiac stimulation. Comparative studies have shown midodrine to be clinically at least as effective as other sympathomimetic agents (norfenefrine, etilefrine, dimetofrine and ephedrine) and dihydroergotamine in this regard. Additionally, midodrine appears to cause less frequent and severe adverse effects associated with alpha-receptor agonism such as piloerection and urinary hesitancy. The most commonly experienced adverse effects--piloerector reactions, gastrointestinal disorders, and cardiovascular complaints--are generally mild and can be controlled by reducing the dosage of midodrine. Thus, midodrine is at least as useful as other currently available options in the management of orthostatic or secondary hypotension, and represents a stepping stone towards optimal therapy.

Authors+Show Affiliations

ADIS Drug Information Services, Auckland, New Zealand.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

2480881

Citation

McTavish, D, and K L. Goa. "Midodrine. a Review of Its Pharmacological Properties and Therapeutic Use in Orthostatic Hypotension and Secondary Hypotensive Disorders." Drugs, vol. 38, no. 5, 1989, pp. 757-77.
McTavish D, Goa KL. Midodrine. A review of its pharmacological properties and therapeutic use in orthostatic hypotension and secondary hypotensive disorders. Drugs. 1989;38(5):757-77.
McTavish, D., & Goa, K. L. (1989). Midodrine. A review of its pharmacological properties and therapeutic use in orthostatic hypotension and secondary hypotensive disorders. Drugs, 38(5), 757-77.
McTavish D, Goa KL. Midodrine. a Review of Its Pharmacological Properties and Therapeutic Use in Orthostatic Hypotension and Secondary Hypotensive Disorders. Drugs. 1989;38(5):757-77. PubMed PMID: 2480881.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Midodrine. A review of its pharmacological properties and therapeutic use in orthostatic hypotension and secondary hypotensive disorders. AU - McTavish,D, AU - Goa,K L, PY - 1989/11/1/pubmed PY - 1989/11/1/medline PY - 1989/11/1/entrez SP - 757 EP - 77 JF - Drugs JO - Drugs VL - 38 IS - 5 N2 - Midodrine, a peripheral alpha-adrenergic agonist, finds use in the clinical management of patients with orthostatic hypotension or hypotension secondary to other clinical conditions or drug therapies. Midodrine is almost completely absorbed after oral administration and undergoes enzymatic hydrolysis to form its pharmacologically active metabolite, de-glymidodrine. In patients with refractory orthostatic hypotension oral midodrine increases standing blood pressure and improves symptoms of orthostatism, such as weakness, syncope, blurred vision and fatigue, without any associated cardiac stimulation. Comparative studies have shown midodrine to be clinically at least as effective as other sympathomimetic agents (norfenefrine, etilefrine, dimetofrine and ephedrine) and dihydroergotamine in this regard. Additionally, midodrine appears to cause less frequent and severe adverse effects associated with alpha-receptor agonism such as piloerection and urinary hesitancy. The most commonly experienced adverse effects--piloerector reactions, gastrointestinal disorders, and cardiovascular complaints--are generally mild and can be controlled by reducing the dosage of midodrine. Thus, midodrine is at least as useful as other currently available options in the management of orthostatic or secondary hypotension, and represents a stepping stone towards optimal therapy. SN - 0012-6667 UR - https://www.unboundmedicine.com/medline/citation/2480881/Midodrine__A_review_of_its_pharmacological_properties_and_therapeutic_use_in_orthostatic_hypotension_and_secondary_hypotensive_disorders_ L2 - https://dx.doi.org/10.2165/00003495-198938050-00004 DB - PRIME DP - Unbound Medicine ER -