Midodrine Hydrochloride, Oral MY-doh-dreen hy-droh-KLOR-ide

What are other names for this medicine?

Type of medicine: antihypotensive (treats low blood pressure)

Generic and brand names: midodrine hydrochloride, oral

What is this medicine used for?

This medicine is taken by mouth to keep your blood pressure from becoming too low when you are standing up. Getting up after lying down or sitting normally causes the blood pressure to drop. If your blood pressure drops too much, you may become dizzy or have other problems.

This medicine may be used for other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• an overactive thyroid
• diabetes
• glaucoma
• heart disease
• high blood pressure
• kidney problems
• liver problems
• pheochromocytoma (a tumor on the adrenal gland)
• trouble urinating
• vision problems

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as directed by your healthcare provider. Do not stop taking this medicine without your healthcare provider's approval.

Take it during the day while you are in an upright position. This medicine may raise your blood pressure too much when you are lying down. Do not take this medicine after your evening meal or less than 4 hours before going to bed.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: flushing, headache, pounding heartbeat, blurred vision, trouble urination, chills, fainting.

What should I watch out for?

If your blood pressure increases while you are lying down, your healthcare provider may want you to sleep with the head of your bed elevated (raised).

This medicine may make you dizzy, drowsy or cause headaches. Do not drive or operate machinery unless you are fully alert.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

While taking this medicine, you need to have your blood pressure checked regularly. You may also need to have blood tests regularly to see how this medicine affects you. Talk with your healthcare provider about this.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away). If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; chest pain or tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report these to your healthcare provider): Dizziness, blurred vision, pounding in your ears, sudden confusion, chest pain, fast heartbeat, headache, trouble urinating, severe stomach pain.

Other: Itching, goosebumps, rash, face flushing, dry mouth, trouble sleeping, leg cramps, back pain, nausea, gas, tingling scalp, nervousness.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• ACE inhibitors such as benazepril (Lotensin), captopril, enalapril (Vasotec), fosinopril, lisinopril (Prinivil, moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), and ramipril (Altace), Zestril)
• alpha blockers such as doxazosin (Cardura), prazosin (Minipress), and terazosin (Hytrin)
• angiotensin receptor II blockers such as azilsartan (Edarbi), candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar), losartan/HCTZ (Hyzaar), olmesartan (Benicar), telmisartan (Micardis), and valsartan (Diovan)
• antidepressants such as amitriptyline, desipramine (Norpramin), doxepin, imipramine (Tofranil), nortriptyline (Pamelor), and protriptyline (Vivactil)
• antipsychotics such as chlorpromazine, fluphenazine, prochlorperazine, thioridazine, and trifluoperazine
• antiarrhythmics (medicines to treat irregular heartbeat) such as amiodarone (Cordarone, Pacerone), flecainide (Tambocor), procainamide (Procan SR), and quinidine
• beta blockers such as acebutolol (Sectral), atenolol (Tenormin), carvedilol (Coreg), labetalol (Trandate), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), pindolol, propranolol (Inderal LA), sotalol (Betapace), and timolol
• calcium channel blockers such as amlodipine (Norvasc), diltiazem (Cardizem, Tiamate, Tiazac, Cartia XT), felodipine, nifedipine (Procardia, Adalat), and verapamil (Calan, Isoptin, Verelan)
• clonidine (Catapres)
• cough and cold medicines that contain ephedrine, phenylephrine (Neo-Synephrine, Alconefrin), or pseudoephedrine (Sudafed)
• digoxin (Lanoxin)
• dihydroergotamine (DHE 45, Migranal)
• diuretics such as furosemide (Lasix), hydrochlorothiazide (HCTZ, Microzide), triamterene (Dyrenium), and triamterene/HCTZ (Dyazide, Maxzide)
• fludrocortisone (Florinef)
• medicines to treat stomach acid such as cimetidine (Tagamet) and ranitidine (Zantac)
• metformin (Glucophage, Glucovance)
• methyldopa
• nitrates such as isosorbide dinitrate (Isordil), isosorbide mononitrate (ISMO, Monoket, Imdur), and nitroglycerin (Nitro-Dur)
• promethazine (Phenergan)
• risperidone (Risperdal)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.