Midodrine for postural hypotension

About midodrine

Midodrine is used to treat the problem of having low blood pressure when standing up from a sitting position or when already standing. This condition is known as postural hypotension, or alternatively, orthostatic hypotension. A drop in your blood pressure when you stand up can make you feel dizzy and light-headed, or cause you to faint. This can also put you at risk of falling over. Other symptoms include blurred vision, weakness or tiredness (fatigue), feeling sick (nausea) a fast heartbeat (palpitations) and headaches.

Postural hypotension can have a number of underlying causes. It may be caused by taking certain medicines or if you become lacking in fluid in the body (dehydrated) due to being sick (vomiting) or having diarrhoea. If this is the case, standing up slowly or sitting upright first before standing may help to manage your symptoms. Postural hypotension may also be caused by an underlying problem with your nervous system such as Malattia di Parkinson oppure neuropatia periferica.

Midodrine is used when severe symptoms are being caused by a problem with your nervous system and other forms of treatment have not helped. It works by stimulating certain parts of your nervous system (alpha receptors) which has the effect of narrowing your blood vessels. As your blood vessels narrow, your blood pressure goes up. This helps stop any dizziness or fainting when you stand up.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking midodrine it is important that your doctor knows:

• Se sei incinta, stai cercando di avere un bambino o stai allattando.

• Se hai la pressione alta (ipertensione).

• If you have been told you have a disorder of the nervous system.

• Se hai una condizione cardiaca o qualsiasi problema con i tuoi vasi sanguigni.

• If you have any problems with your prostate gland or if you have difficulty passing urine.

• If you have any problems with the way your kidneys or liver work.

• If you have glaucoma, a condition which causes raised pressure in the eye(s).

• If you have diabetes mellitus, a condition which raises your blood sugar levels. In particular, if your diabetes has caused any problems with your vision.

• Se hai una ghiandola tiroidea iperattiva (ipertiroidismo).

• Se hai un tumore sulla ghiandola surrenale, chiamato feocromocitoma.

• Se hai mai avuto una reazione allergica a un medicinale.

• Se stai assumendo altri medicinali. Questo include qualsiasi medicinale che stai assumendo e che è disponibile per l'acquisto senza prescrizione medica, così come i medicinali a base di erbe e complementari.

• Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The manufacturer's leaflet will give you more information about midodrine and a full list of side-effects which you may experience from taking it.

• Take midodrine exactly as your doctor tells you to. Your dose will be written on the label of your pack to remind you.

• The usual starting dose is one 2.5 mg tablet taken three times a day. Your blood pressure will need to be monitored and your dose may be increased each week until you find the lowest dose that controls your blood pressure. The maximum dose is 10 mg three times a day.

• Swallow the tablets with a drink of water. It is not important whether you take your dose before or after food.

• Do not take a dose of midodrine late in the evening, take your last dose of the day at least four hours before your bedtime.

• If you forget to take a dose, take it as soon as you remember unless it is nearly time for your next dose or unless it is within four hours of your bedtime. In these cases leave out the forgotten dose and take your next dose when it is due. Do not take two doses together to make up for a forgotten dose.

• Cerca di mantenere tutti i tuoi appuntamenti regolari con il tuo medico. Questo è per permettere al tuo medico di controllare i tuoi progressi.

• Your blood pressure may need to be monitored when you are lying down and when you are standing up. This is to make sure your blood pressure does not go too high when you are lying down. If your blood pressure does go up when you are lying down then your dose of midodrine may need to be reduced.

• You may find it useful to have a blood pressure meter to use at home. Ask your doctor or pharmacist for advice about testing your blood pressure at home.

• When you are lying down in bed try to keep your head raised - for instance, by using extra pillows. This is to help prevent your blood pressure going too high when you are lying down.

• If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking midodrine.

• If you buy any medicines, check with your doctor or a pharmacist that they are suitable for you to take with midodrine.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with midodrine. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

Importante: taking midodrine may cause your blood pressure to go too high. This can be a particular problem if it happens when you are lying down. Your dose may need to be reduced or your treatment stopped. Your doctor will monitor your blood pressure and it may also help to use a blood pressure meter at home.

Let your doctor know if you think your blood pressure is too high or if you experience symptoms such as:

• Dolore toracico

• A fast heartbeat (palpitations)

• Fiato corto

• Mal di testa

• Visione offuscata

Se si verificano altri sintomi che ritieni possano essere dovuti a questo medicinale, parla con il tuo medico o farmacista.

• Tenere tutti i medicinali fuori dalla portata e dalla vista dei bambini.

• Conservare in un luogo fresco e asciutto, lontano da fonti di calore e luce diretta.

• Midodrine tablets that are packaged in a bottle must be used within eight weeks of opening the bottle.