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Midodrine hydrochloride is a prescription vasopressor used for symptomatic orthostatic hypotension in patients whose daily activities remain substantially impaired despite standard care. Current oral tablets contain 2.5 mg, 5 mg, or 10 mg. Its approved use is based primarily on increased standing systolic blood pressure rather than conclusively demonstrated improvements in daily functioning.
read more about midodrine ...Midodrine is converted to desglymidodrine, an active metabolite that stimulates alpha-1 adrenergic receptors in blood vessels. This causes narrowing of arteries and veins, increasing vascular resistance and blood pressure. Blood pressure can also rise excessively when a patient is lying down.
Midodrine is prescribed for patients with substantial symptoms of orthostatic hypotension that persist despite standard treatment. Therapy continues only when patients show meaningful symptomatic improvement. Severe organic heart disease, acute kidney disease, urinary retention, pheochromocytoma, thyrotoxicosis, and persistent excessive supine hypertension are contraindications.
The recommended dose is 10 mg by mouth three times daily during waking hours, typically in the morning, at midday, and in the late afternoon. Doses are generally separated by approximately four hours. The last dose is taken at least four hours before bedtime to reduce supine hypertension. Patients with impaired kidney function commonly start at 2.5 mg. Supine and standing blood pressure are checked regularly.
Midodrine carries a boxed warning for marked supine hypertension, which can increase the risk of stroke and other cardiovascular complications. Other concerns include slow heart rate, urinary retention, tingling, scalp itching, and goosebumps. Patients are monitored for elevated blood pressure while lying down, and treatment is stopped when severe supine hypertension develops.
Midodrine treats symptomatic orthostatic hypotension in patients whose daily activities remain substantially impaired despite standard care.
The recommended dose is 10 mg three times daily during waking hours.
Taking midodrine too close to bedtime increases the risk of dangerously high blood pressure while lying down.
Yes. Its boxed warning concerns marked supine hypertension and the risk of serious cardiovascular complications.
DailyMed - MIDODRINE HYDROCHLORIDE tablet. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=2d1b58a7-ec7f-f3ea-e063-6294a90a27fb. Date Accessed October 14, 2026.
Midodrine. MedlinePlus. https://medlineplus.gov/druginfo/meds/a616030.html. Date Accessed October 14, 2026.
Midodrine. PubChem. https://pubchem.ncbi.nlm.nih.gov/compound/Midodrine. Date Accessed October 14, 2026.
Midodrine Hydrochloride. PubChem. https://pubchem.ncbi.nlm.nih.gov/compound/Midodrine-hydrochloride. Date Accessed October 14, 2026.
Orthostatic Hypotension. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK448192/. Date Accessed October 14, 2026.