Midodrine - Oral

Midodrine is used in the management of orthostatic hypotension (a condition where there is a sudden fall in blood pressure when standing up from a sitting or lying down position).

Take Midodrine exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.

Take this medicine together with food or immediately after a meal. Your last dose for the day should be taken at least 4 hours before bedtime. Avoid taking Midodrine late in the evening.

Try to take it at the same time each day.

The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on your response to the medication.

Midodrine must be taken at regular intervals for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.

DO NOT double a dose under any circumstances.

If you often forget to take your medicine, let your doctor and pharmacist know.

Alert your doctor if you have the following conditions:

• heart problems e.g. recent heart attack, slow heartbeat, aortic aneurysm (weakness and bulging of the blood vessel wall in the lower major blood vessel away from the heart)
• high blood pressure while lying down
• poorly controlled high blood pressure
• phaeochromocytoma (rare tumour of the adrenal gland causing high blood pressure)
• overactive thyroid gland
• increased pressure in the eyes
• diabetic retinopathy (visual problems related to diabetes)
• urinary retention (inability to completely empty the bladder when urinating)
• sudden kidney problems

as Midodrine may not be suitable for you.

Inform your doctor if you have the following conditions:

• diabetes
• eye problems
• problems in the blood vessels
• problems in the prostate gland
• severe disorders of the nervous system
• liver disease
• kidney disease

Let your doctor know if you are pregnant or breastfeeding.

Be sure to check with your doctor or pharmacist before giving Midodrine to the elderly. Elderly people may be more sensitive to the side effects.

Why is it important to keep my appointments with the doctor?

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.

• Routine tests (e.g. liver or kidney function) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
• Your blood pressure may rise to unsafe levels without you noticing it. Monitor your blood pressure regularly during treatment.

What lifestyle changes can I make to improve my blood pressure?

Regular exercise and eating a healthy diet will help control your blood pressure and improve your overall health. Engage in physical activity like walking for at least 30 to 60 minutes on most days of the week. If you have not exercised for a long time, start with light exercises such as slow walks. Speak to your doctor about what type of exercise would be suitable for you. Follow a healthy diet plan by eating more fruits, vegetables, whole grains and low-fat dairy products and reduce your intake of foods high in saturated fat, cholesterol and sodium. Cutting down on deep-fried foods and using less salt when cooking can kick-start your healthy diet.

If you smoke, you should try to quit. Smoking is harmful to your blood pressure, heart and overall health. Speak to your doctor or pharmacist about ways to stop your smoking habit.

Midodrine may cause any of the following side effects: headache, stomach pain, indigestion, chills, goose bumps, flushing, numbness or tingling sensation in hands and feet, skin rash, and itching of scalp.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:

• chest pain, palpitation, shortness of breath, blurred vision, severe headache, dizziness
• slow heartbeat
• pain or difficulty in passing urine

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.

Inform your doctor and pharmacist if you are taking any of these medicines:

• medicines for high blood pressure e.g. reserpine, guanethidine
• medicines for cold or allergy e.g. phenylpropanolamine, phenylephrine, pseudoephedrine
• medicine to treat symptoms of enlarged prostate gland e.g. prazosin, doxazosin, terazosin
• anti-inflammatory medicines e.g. fludrocortisone
• medicines for depression
• digoxin (medicine for heart disease)

This list does not include all medicines that may interact with Midodrine.

Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.

Avoid alcohol.

Store in a cool, dry place away from the reach of children.

Medicines must not be used past the expiry date.