Side Effects of midodrine: A Synthesis of Findings from 19 Studies

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Original Abstract of the Article

Major Research Findings

Midodrine is a medication approved by the FDA to treat orthostatic hypotension, a condition where blood pressure drops when standing up. 3 . It works by constricting blood vessels, which helps to raise blood pressure. 3 . While generally effective, midodrine can cause side effects such as bradycardia, high blood pressure when lying down, and tingling sensations. 3 . One study reported a unique side effect of nightmares associated with midodrine use. 3 .

Reasons for Side Effects

Midodrine's side effects are primarily due to its action of constricting blood vessels. This constriction can affect various bodily functions, leading to side effects. 3 .

Common Side Effects

Bradycardia

Midodrine can slow down your heart rate. 3 .

Supine Hypertension

Your blood pressure may rise when you are lying down. 3 .

Paresthesia

You might experience tingling sensations or numbness in your limbs. 3 .

Nightmares

Midodrine has been linked to experiencing nightmares. 3 . The researchers suggest that autonomic dysfunction, which is a disruption in the nervous system's control of bodily functions, could be a factor. 3 .

Side Effect Countermeasures

Bradycardia Countermeasures

If you experience severe bradycardia, you might need to stop taking midodrine. 3 . Consult your doctor.

Supine Hypertension Countermeasures

If you are concerned about supine hypertension, your doctor may recommend adjusting the timing of your midodrine doses. 3 .

Paresthesia Countermeasures

If you experience severe paresthesia, you might need to stop taking midodrine. 3 . Consult your doctor.

Nightmares Countermeasures

If you experience frequent or severe nightmares, your doctor may advise adjusting the timing of your midodrine doses, potentially avoiding nighttime doses and taking them during the day. 3 .

Comparison Between Studies

Commonalities Between Studies

Many studies have shown that midodrine is effective in treating orthostatic hypotension. 13 , 17 , 15 , 18 , 14 , 12 , 11 , 4 , 9 , 6 . They also generally agree that midodrine is a safe medication. 13 , 17 , 15 , 18 , 14 , 12 , 11 , 4 , 9 , 6 .

Differences Between Studies

Some studies highlight the potential benefits of midodrine in specific situations. 13 , 15 , 18 , 17 , 14 , 12 , 11 , 4 , 9 , 6 . For instance, 13 demonstrated its effectiveness in treating hypotension after carotid artery stenting. 13 . 17 found midodrine beneficial in reducing symptoms for patients with neurocardiogenic syncope. 17 .

Practical Applications and Precautions

Midodrine can be a helpful treatment for conditions like orthostatic hypotension, but it's crucial to take it as prescribed by your doctor. 3 , 13 , 17 , 15 , 18 , 14 , 12 , 11 , 4 , 9 , 6 . Remember that midodrine can cause side effects, so it's important to be aware of these and discuss any concerns with your doctor. 3 . If you are older or have heart conditions, it's particularly important to consult your doctor before taking midodrine. 3 .

Limitations of Current Research

The research on midodrine's side effects is still limited. 3 , 13 , 17 , 15 , 18 , 14 , 12 , 11 , 4 , 9 , 6 . More research is needed to understand the full range of side effects, particularly those associated with long-term midodrine use. 3 .

Future Directions for Research

More research on the side effects of midodrine is necessary. 3 . It's particularly important to understand the long-term effects of midodrine on the body. 3 . Additionally, research focused on finding ways to minimize midodrine's side effects is essential. 3 .

Conclusion

Midodrine is an effective medication for treating orthostatic hypotension, but it can also cause side effects. 3 , 13 , 17 , 15 , 18 , 14 , 12 , 11 , 4 , 9 , 6 . It's vital to follow your doctor's instructions carefully when taking midodrine and be aware of any potential side effects. 3 . If you have any questions or concerns, don't hesitate to discuss them with your doctor.

Literature analysis of 19 papers
Positive Content
14
Neutral Content
2
Negative Content
3
Article Type
5
0
3
6
18
1.

Folic acid and folinic acid for reducing side effects in patients receiving methotrexate for rheumatoid arthritis.

Author: SheaBeverley, SwindenMichael V, Tanjong GhogomuElizabeth, OrtizZulma, KatchamartWanruchada, RaderTamara, BombardierClaire, WellsGeorge A, TugwellPeter

Reduced side effects
Gastrointestinal side effects
Hematologic side effects
Hepatic side effects
Mucosal side effects

Methotrexate (MTX) is a drug used to treat rheumatoid arthritis. The review discusses the potential for folic or folinic acid supplementation to ameliorate side effects associated with MTX treatment.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

2.

Side effects of methotrexate therapy for rheumatoid arthritis: A systematic review.

Author: WangWanying, ZhouHua, LiuLiang

RA treatment
Gastrointestinal toxicity
Malignant diseases

Methotrexate is an effective treatment for rheumatoid arthritis (RA), but can cause side effects ranging from mild to severe. Careful monitoring and dose adjustments can help minimize these risks.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

3.

Midodrine-Induced Nightmares in the Treatment of Orthostatic Hypotension: A Case Report.

Author: TranLara, BrodeurMichael

Improved blood pressure
Nightmares

This case report describes a unique adverse event of nightmares caused by midodrine, a medication used to treat orthostatic hypotension. The patient experienced increased nightmares after starting midodrine, despite the improvement in his blood pressure.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

4.

Midodrine Improves the Tolerability of Diuretics in Patients with Acute-on-Chronic Liver Failure-A Pilot Study.

Author: KulkarniAnand V, KumarPramod, SharmaMithun, RavikumarSowmya T, TevethiaHarshvardhan, VasireddySamragni, GuptaRajesh, ReddyDuvvuru N, RaoPadaki N

ACLF treatment

This study evaluated the role of midodrine in the treatment of acute-on-chronic liver failure (ACLF).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

6.

Droxidopa as an effective treatment for refractory neurogenic orthostatic hypotension and reflex bradycardia in amyloid light-chain amyloidosis: a case report.

Author: HoAnnie H, KinterChristopher W, WightJohn, NeelamAnudeep R, KrakowDavid

Neurogenic orthostatic hypotension treatment

Droxidopa is a treatment for neurogenic orthostatic hypotension. This paper reviews the use of droxidopa in patients with neurogenic orthostatic hypotension due to amyloidosis, highlighting its potential benefits in treating this often severe and refractory condition. The paper also discusses the concomitant use of midodrine and droxidopa and proposes a protective effect of droxidopa against episodes of reflex bradycardia.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

8.

The Role of Midodrine for Hypotension Outside of the Intensive Care Unit.

Author: GutmanLawrence B, WilsonBen J

Ascites treatment
Intradialytic hypotension treatment
Orthostatic hypotension treatment
Paresthesia
Piloerection
Scalp pruritis
Urinary retention

Midodrine, an alpha-adrenergic agonist, is used to treat orthostatic hypotension. It may be beneficial for treating vasoplegic conditions such as sepsis, but more research is needed.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

9.

Midodrine for orthostatic hypotension and recurrent reflex syncope: A systematic review.

Author: IzcovichAriel, González MallaCarlos, ManzottiMatias, CatalanoHugo Norberto, GuyattGordon

RRS treatment
SOH treatment

This systematic review evaluated the efficacy and safety of midodrine in managing symptomatic orthostatic hypotension (SOH) and recurrent reflex syncope (RRS). The review aims to determine if midodrine improves patient outcomes and assess its safety profile.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

10.

Management of ascites in patients with liver cirrhosis: recent evidence and controversies.

Author: HsuShao-Jung, HuangHui-Chun

Increased morbidity
Increased mortality

This review discusses strategies to prevent and properly manage ascites-related complications, including a review of the literature and controlled studies that assess these strategies.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

11.

Effectiveness of midodrine treatment in patients with recurrent vasovagal syncope not responding to non-pharmacological treatment (STAND-trial).

Author: RommeJacobus J C M, van DijkNynke, Go-SchönIngeborg K, ReitsmaJohannes B, WielingWouter

Initial treatment for vasovagal syncope (VVS) includes fluid and salt intake, exercise, and counterpressure manoeuvres. This study investigated whether additional Midodrine treatment is effective in patients who continue to experience regular episodes of VVS.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

12.

[Efficacy of midodrine hydrochloride in the treatment of children with vasovagal syncope].

Author: LiuXiao-Yan, WangCheng, WuLi-Jia, HuChun-Yan, LinPing, LiMing-Xiang, CuiXiao-Li, XieZhen-Wu

Pediatric VVS treatment
Vasovagal syncope treatment

Midodrine hydrochloride is effective and safe in treating pediatric VVS, with significantly lower recurrence rates than other treatment groups. It enhances the efficacy of conventional therapies like health education and cresol.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : Chinese

13.

Oral midodrine is effective for the treatment of hypotension associated with carotid artery stenting.

Author: SharmaSanjiv, LardizabalJoel A, BhambiBrijesh

Treat CAS hypotension

Midodrine, an oral agent, may be a viable alternative to intravenous vasopressors for treating hypotension during carotid artery stenting (CAS). In this study, patients who received midodrine experienced successful recovery and discharge without complications, similar to those who received dopamine.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

14.

The efficacy of midodrine hydrochloride in the treatment of children with vasovagal syncope.

Author: QingyouZhang, JunbaoDu, ChaoshuTang

Reduced syncope recurrence
VVS prevention

Midodrine hydrochloride was effective in treating vasovagal syncope in children, especially in preventing recurrent episodes. Few side effects were observed.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

15.

[Comparative efficacy and tolerance of atenolol and midodrine in patients with vasovagal syncopes].

Author: KuchinskaiaE A, PevznerA V, VershutaE V, Al'bitskaiaK V, KheĭmetsG I, RogozaA N, GolitsynS P

Effective VVS treatment
Well tolerated

Atenolol and midodrine were both effective and well tolerated in treating vasovagal syncopes (VVS). Combined use of the drugs was effective in patients resistant to monotherapy.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : Russian

16.

Synthesis and structure-activity studies on N-[5-(1H-imidazol-4-yl)-5,6,7,8-tetrahydro-1-naphthalenyl]methanesulfonamide, an imidazole-containing alpha(1A)-adrenoceptor agonist.

Author: AltenbachRobert J, KhilevichAlbert, KolasaTeodozyj, RohdeJeffrey J, BhatiaPramila A, PatelMeena V, SearleXenia B, YangFan, BunnelleWilliam H, TietjeKarin, BayburtErol K, CarrollWilliam A, MeyerMichael D, HenryRodger, BucknerSteven A, KukJane, DazaAnthony V, MilicicIvan V, CainJohn C, KangChae H, IrelandLynne M, CarrTracy L, MillerThomas R, HancockArthur A, NakaneMasaki, EsbenshadeTimothy A, BruneMichael E, O'NeillAlyssa B, GauvinDonna M, KatwalaSweta P, HolladayMark W, BrioniJorge D, SullivanJames P

Urinary retention treatment
Uroselectivity
Cardiovascular side effects

This study explores the structure-activity relationship of alpha(1A)-adrenoceptor (AR) selective agonists. The research suggests that increased alpha(1A) selectivity can reduce cardiovascular side effects while still maintaining uroselective activity.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

17.

Usefulness of midodrine in patients with severely symptomatic neurocardiogenic syncope: a randomized control study.

Author: Perez-LugonesA, SchweikertR, PaviaS, SraJ, AkhtarM, JaegerF, TomassoniG F, SalibaW, LeonelliF M, BashD, BeheiryS, ShewchikJ, TchouP J, NataleA

Syncope treatment
Side effects

Midodrine was significantly more effective than fluid therapy in treating patients with neurocardiogenic syncope. 81% of midodrine-treated patients remained asymptomatic after 6 months, compared to only 13% of the fluid therapy group.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

18.

Reversal of type 1 hepatorenal syndrome with the administration of midodrine and octreotide.

Author: AngeliP, VolpinR, GerundaG, CraigheroR, RonerP, MerendaR, AmodioP, SticcaA, CaregaroL, Maffei-FaccioliA, GattaA

Improves renal function
Reduces plasma glucagon
Reduces plasma renin activity
Reduces plasma vasopressin

Midodrine and octreotide, when administered together, may be an effective and safe treatment for type 1 hepatorenal syndrome in patients with cirrhosis.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

19.

[Pharmacologic approach to autonomic failure].

Author: SenardJ M, MontastrucJ L

Treatment of orthostatic hypotension
Side-effects

The article discusses various pharmacological approaches to understanding and treating autonomic failure, focusing on central, presynaptic, and post-synaptic mechanisms. Several medications, including fludrocortisone, erythropoietin, midodrine, clonidine, yohimbine, and L-Threo-DOPS, are reviewed for their efficacy and side effects in managing orthostatic hypotension.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : French

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