Midodrine hydrochloride
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Classification: Treat orthostatic hypotension Action/Kinetics: Midodrine, a prodrug, is converted to an active metabolite--desglymidodrine--that is an alpha-1 agonist. Desglymidodrine produces an increase in vascular tone and elevation of BP by activating alpha-adrenergic receptors of the arteriolar and venous vasculature. No effect on cardiac beta-adrenergic receptors. The active metabolite does not cross the blood-brain barrier; thus, there are no CNS effects. Standing systolic BP is increased by approximately 15-30 mm Hg at 1 hr after a 10-mg dose; duration: 2-3 hr. Rapidly absorbed from the GI tract. Peak plasma levels, midodrine: 30 min; t 1/2: 25 min. Peak plasma levels, desglymidodrine: 1-2hr; t 1/2: 3-4 hr. The bioavailability of the active metabolite is not affected by food. Desglymidodrine is eliminated in the urine. Uses: Orthostatic hypotension in those whose lives are significantly impaired despite standard clinical care. Investigational: Management of urinary incontinence. Contraindications: Use in severe organic heart disease, acute renal disease, urinary retention, pheochromocytoma, thyrotoxicosis, persistent and excessive supine hypertension. Special Concerns: Use with caution in impaired renal or hepatic function, during lactation, in orthostatic hypotensive clients who are also diabetic, or in those with a history of visual problems or who are also taking fludrocortisone acetate. Safety and efficacy have not been determined in children. Side Effects: CNS: Paresthesia, pain, headache, feeling of pressure or fullness in the head, confusion, abnormal thinking, nervousness, anxiety. Rarely, dizziness, insomnia, somnolence. GI: Dry mouth. Rarely, canker sore, nausea, GI distress, flatulence. Dermatologic: Piloerection, pruritus, rash, vasodilation, flushed face. Rarely, erythema multiforme, dry skin. Miscellaneous: Dysuria, supine hypertension. Rarely, visual field defect, skin hyperesthesia, impaired urination, asthenia, backache, pyrosis, leg cramps. Overdose Management: S ymptoms: Hypertension, piloerection, sensation of coldness, urinary retention. Treatment: Emesis and administration of an alpha-adrenergic blocking agent (e.g., phentolamine).
Drug Interactions:
How Supplied: Tablet: 2.5 mg, 5 mg
Dosage
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