Midodrine - Oral


The Food and Drug Administration (FDA) has issued a boxed warning for midodrine. Boxed warnings are the agency’s strongest warnings for serious and potentially life-threatening risks.

The boxed warning: Midodrine is known to cause hypertension (high blood pressure) which occurs when lying flat on your back. The medication is only given to those with hypotension (low blood pressure) which limits their ability to perform normal tasks and cannot be treated by other medications.

What Is Midodrine?

Midodrine is an orally administered prescription oral medication used to treat orthostatic hypotension, or the sudden fall of blood pressure when standing after sitting or lying down. Orthostatic refers to an upright posture, also known as postural hypotension.

Midodrine is classified as a sympathomimetic (an alpha-1 adrenergic agonist) and is approved for adults 18 and older. 

Alpha-adrenergic agonists are medications used to treat hypertension among other cardiovascular issues, such as septic shock, hypotension, and cardiopulmonary (sudden loss of heart function) arrest.

Midodrine comes in 2.5 milligrams, 5 milligrams, and 10 milligrams doses.

Midodrine works by activating the nerve endings in blood vessels to tighten, which increases blood pressure.

No current brand-name version of midodrine exists. However, midodrine exists as a generic product available in the form of an oral (taken by mouth) tablet.

Drug Facts

Generic Name: Midodrine

Brand Name(s): N/A

Drug Availability: Prescription

Administration Route: Oral

Therapeutic Classification: Vasopressor

Available Generically: Yes

Controlled Substance: N/A

Active Ingredient: Midodrine hydrochloride

Dosage Form(s): Tablet

What Is Midodrine Used For?

The Food and Drug Administration (FDA) has approved midodrine as an oral therapy to treat orthostatic hypotension in adults.

Orthostatic hypotension is a condition that causes a drop in blood pressure when moving from a lying or sitting position to a standing position. This drop in blood pressure can cause dizziness and even fainting.

In people with orthostatic hypotension, hypoperfusion (reduced blood flow) to other organs can lead to an increased chance of serious health issues, such as heart attackatrial fibrillation (AFib; heart rhythm abnormalities), stroke, or chronic kidney disease (CKD).

How to Take Midodrine

Midodrine must be taken by mouth, with a standard dose being taken three times a day during daytime hours. The doses need to be taken at least three hours apart and can be taken in the morning, afternoon, and late afternoon (before 6 p.m.).

The last dose should be taken before the evening meal and at least four hours before bedtime. Use it during daytime hours when you need to be active and standing. Don't take a dose if you will be lying down for any length of time.

This medication can be taken with or without food. It is recommended not to lie down after taking this drug as it can increase your blood pressure. Finally, take midodrine at the same times every day.


Keep midodrine stored at room temperature (68 F to 77 F) in a safe, dry location.

Also, keep out of reach of children and pets. Be sure to throw away unused or expired drugs, but do not flush them down a toilet or pour them down a drain unless you are told to do so by a healthcare provider.

It is recommended that you discuss with your healthcare provider if you have questions about the best way to throw away expired/unwanted drugs. Keep in a dry place away from light and out of reach of children and pets.

Off-Label Uses

Midodrine can be used as an off-label medication in people with heart failure with reduced ejection fraction (a type of heart failure that causes less oxygen-rich blood to reach the rest of your body from the heart than normal).

Also, midodrine can be used in the treatment of intradialytic hypotension (IDH; low blood pressure as a result of dialysis).

How Long Does Midodrine Take to Work?

Midodrine will take around one hour to work and reach its maximum effect, lasting two to three hours.

What Are the Side Effects of Midodrine?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

Common side effects of midodrine may include:

Severe Side Effects

Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you have a medical emergency.

Serious side effects and their symptoms can include the following:

Long-Term Side Effects

The long-term side effects associated with the use of midodrine include: 

  • Dizziness
  • Headache
  • Anxiety or nervousness

Report Side Effects

Midodrine may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Midodrine Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For low blood pressure:
      • Adults—10 milligrams (mg) three times a day in approximately 4-hour intervals during daytime hours: shortly before or upon rising in the morning, at midday, and in the late afternoon (not later than 6 p.m.). Your doctor may increase your dose if needed.
      • Children—Use and dose must be determined by your doctor.


In some cases, your healthcare provider may need to adjust the use of your treatment or dosage:

Pregnancy: There are no adequate studies on pregnant people. Midodrine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Breastfeeding: It is not known whether this drug is expelled through human milk. Because drugs are commonly expelled through human milk, caution should be used when midodrine is given to a nursing person.

Children: Midodrine is not recommended for people under 18 since it has not been adequately studied in this age group.

Kidney issues: If you have kidney problems, your healthcare provider may be cautious and start you on a lower dose, such as 2.5 milligrams.

Missed Dose

Take the missed dose as soon as you remember it. If it is almost time for the next dose, skip the missed dose and continue your regular schedule.

Do not take a double dose to make up for missed doses, as this may lead to an overdose. The last dose should be four hours before your bedtime and preferably before the evening meal.

Overdose: What Happens If I Take Too Much Midodrine?

If you take too much midodrine, you may experience hypertension, bradycardia, fatigue, and headache.

Overdosing on midodrine is rare, but if you or someone else has taken more than the recommended dose of midodrine and is experiencing side effects, it is best to call the Poison Control Center to ask for guidance or to go to a local emergency room for evaluation.

What Happens If I Overdose on Midodrine?

If you think you or someone else may have overdosed on midodrine, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking midodrine, call 911 immediately.


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Do not take other medicines unless they have been discussed with your doctor. This especially includes over-the-counter (nonprescription) medicines for appetite control, asthma, colds, cough, hayfever, or sinus problems, since they may tend to increase your blood pressure.

What Are Reasons I Shouldn’t Take Midodrine?

You should avoid midodrine if you have heart disease, kidney disease, urinary retention (trouble emptying your bladder completely), pheochromocytoma (a type of tumor), or thyrotoxicosis (excessive thyroid hormone).

Your healthcare provider will help you determine if midodrine is the right medication for you.

What Other Medications Interact With Midodrine?

Midodrine may interact with other drugs. Before starting treatment, tell your healthcare provider about all your medications, including prescription or over-the-counter (OTC) medications, vitamins, and herbal products.

Please inform your healthcare provider if you are taking any of the drugs below as they can interact with midodrine as most of them increase the risk of high blood pressure:

What Medications Are Similar?

Other medications may be used to treat orthostatic hypotension, including but not limited to:

  • Vazculep (phenylephrine hydrochloride injection): Similar to midodrine, Vazculep belongs to the alpha-1 agonist class of drugs. It treats hypotension episodes from anesthesia.
  • Northera (droxidopa): Used to treat dizziness, lightheadedness, and orthostatic hypotension caused by Parkinson's disease.
  • Regonol (pyridostigmine): Unlike midodrine, Regnonol is an injection; however, it can be used for orthostatic hypotension.

Frequently Asked Questions

  • What should I do if I miss a dose of midodrine?

    If you miss a dose, take it as soon as you remember. If it's near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

  • When is the latest time in the day to take the last dose?

    The last dose should be taken four hours before bedtime and preferably before the evening meal.

  • Can I take the medication whenever I need to?

    The medication must be taken as prescribed by your healthcare provider. Do not take less or more than prescribed.

How Can I Stay Healthy While Taking Midodrine?

To stay healthy while taking midodrine, it is important to take it as directed by your healthcare provider.

It may be difficult to initially take it consistently, but to treat your symptoms effectively; it must be taken as prescribed. It is recommended to use a tool to remind you when taking this medication.

It is important to follow up with your healthcare provider for recommended visits and inform them of any other drugs you plan to take as they may interact with the medication.

In addition, please monitor your blood pressure at home, and report side effects to your healthcare provider.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. DailyMed. Label: midodrine hydrochloride tablet.

  2. ScienceDirect. Alpha-adrenergic agonist.

  3. MedlinePlus. Midodrine.

  4. MedlinePlus. Orthostatic hypotension.

  5. DailyMed. Midodrine hydrochloride tablet.

  6. Hajjiah A, Maadarani O, Bitar Z, et al. Use of midodrine in heart failure: two case reports and a review of the literatureEur J Case Rep Intern Med. 2022;9(3):003246. doi:10.12890/2022_003246

  7. Food and Drug Administration. Vazculep prescribing information.

  8. Food and Drug Administration. Northera prescribing information.

  9. Food and Drug Administration. Regonol (pyridostigmine) prescribing information.