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Midodrine is indicated for the treatment of symptomatic orthostatic hypotension. It can reduce dizziness and faints by about a third, but can be limited by troublesome goose bumps, skin itch, gastrointestinal discomfort, chills, elevated blood pressure while lying down, and urinary retention. [7]
For hypotension, it is specifically used in the treatment of neurogenic orthostatic hypotension (NOH) in dopamine β-hydroxylase deficiency, [7] as well as NOH associated with multiple system atrophy (MSA), [9] familial amyloid polyneuropathy (FAP), and pure autonomic failure (PAF). [10]
Orthostatic hypotension, also known as postural hypotension, [2] is a medical condition wherein a person's blood pressure drops when they are standing up (orthostasis) or sitting down. Primary orthostatic hypotension is also often referred to as neurogenic orthostatic hypotension. [ 3 ]
Fludrocortisone is the first-line therapy (in the absence of heart failure) for patients with chronic hypotension or resistant orthostatic hypotension. [17] It works by increasing the intravascular volume. [17] Midodrine is a therapy used for severe orthostatic hypotension, and works by increasing peripheral vascular resistance. [17]
[2] [4] If this is insufficient for treating vasovagal syncope, medications such as midodrine or fludrocortisone may be tried. [4] Occasionally, a cardiac pacemaker may be used as treatment. [2] Reflex syncope affects at least 1 in 1,000 people per year. [1] It is the most common type of syncope, making up more than 50% of all cases. [2]
The majority of symptoms that patients with PAF exhibit are associated with neurogenic orthostatic hypotension, or orthostatic hypotension brought on by severe sympathetic failure. Within three minutes of standing up straight, orthostatic hypotension is defined as a drop in systolic blood pressure of at least 20 mm Hg or a drop in diastolic ...
By reducing alpha-1-adrenergic activity of the blood vessels, these drugs may cause hypotension (low blood pressure) and interrupt the baroreflex response. In doing so, they may cause dizziness, lightheadedness, or fainting when rising from a lying or sitting posture (known as orthostatic hypotension or postural hypotension). For this reason ...
[1] [2] [3] It is assumed to be a manifestation of disorders of the autonomic nervous system [4] or due to side effects of medications such as midodrine and droxidopa. [ 5 ] [ 6 ] References
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