{"id":4560,"date":"2025-03-31T18:12:12","date_gmt":"2025-03-31T18:12:12","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/midodrine-hydrochloride-txt\/"},"modified":"2025-03-31T18:12:12","modified_gmt":"2025-03-31T18:12:12","slug":"midodrine-hydrochloride-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/midodrine-hydrochloride-txt\/","title":{"rendered":"midodrine hydrochloride.txt"},"content":{"rendered":"

CLINICAL USE <\/H3>
\nTreatment of orthostatic hypotension, including dialysis related hypotension

DOSE IN NORMAL RENAL FUNCTION <\/H3>Hypotension: 2.5 mg twice daily up to 10 mg 3 times a day

PHARMACOKINETICS <\/H3>
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :290.7<\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Negligible<\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp : 2<\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp :No data<\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp :25 minutes (3 hours for active metabolite)\/increased (9 for active metabolite)

    DOSE IN RENAL IMPAIRMENT <\/H3>

    GFR (mL\/MIN)<\/H4>
  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function. Start with a lower dose and titrate according to response
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Dose as in normal renal function. Start with a lower dose and titrate according to response

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Dialysed. Dose as in GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL\/min<\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Dialysed. Initial dose, 2.5 mg if 70 kg.
  • HDF\/high flux &nbsp :Dialysed. Initial dose, 2.5 mg if 70 kg.
  • CAV\/VVHD &nbsp &nbsp &nbsp:Dialysed. Dose as in GFR=10\u201320 mL\/min

    IMPORTANT DRUG INTERACTIONS <\/H3>Potentially hazardous interactions with other drugsRisk of arrhythmias if given with volatile anaestheticsRisk of arrhythmias and hypertension if given with tricyclic antidepressants and MAOIsRisk of severe hypertension if given with beta-blockersOther drugs which increase blood pressure: enhanced hypertensive effect

    ADMINISTRATION <\/H3>

    Reconstition<\/H4>\u2013

    Route <\/H4>Oral

    Rate of Administration <\/H4>\u2013

    Comments<\/H4>Take last dose at least 4 hours before bed

    OTHER INFORMATION <\/H4>Metabolised to an active metabolite (desglymidodrine)After dialysis only 15% of drug remaining, so effectively removed by dialysisHypertension post dialysis is not a problem because drug is dialysed outPeak levels occur 30 minutes after administration (60 minutes for active metabolite) so give 30 minutes before dialysis \u2013 avoid in patients with active coronary ischaemia93% bioavailability For haemodialysis patients, start at a low dose and increase to a maximum of 30 mg; a second dose can be given midway through dialysis (maximum dose 10 mg)\n
  • Contraindicated in severe organic heart disease, urinary retention, phaeochromocytoma and thyrotoxicosis
    \n","protected":false},"excerpt":{"rendered":"

    CLINICAL USE Treatment of orthostatic hypotension, including dialysis related hypotension<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-4560","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4560","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=4560"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4560\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=4560"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=4560"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=4560"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}