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Medication Description: Midodrine (Midodrine)

MIDODRINE (Midodrine) *. (#) - 2-Amino-N- (2, 5-dimethoxy-b-hydroxyphenethyl) acetamide.

Synonyms: Gutron (The name of the drug company "Hafslund Nycomed Pharma AG"), Alphamine, Gutron, Hipertan, Midamine, etc.

Available in the form of hydrochloride.

In terms of chemical structure and pharmacological properties, midodrin is similar to adrenaline-like sympathomimetic substances. It has a vasoconstrictor and pressor (hypertensive) effect. Like noradrenalin and mezaton, it stimulates mainly a - adrenoreceptors, having little effect on b - adrenoreceptors; does not have a significant effect on heart rate, myocardial contractility, and also on the muscles of the bronchi.

In the body, midodrin is hydrolyzed to form the active metabolite of de-glymidodrine and aminoacetic acid (see Glycine).

Deglimidodrin differs much more vasoconstrictor (sympathomimetic) action than the original compound midodrin; Thus, midodrin is considered as a "prodrug", from which an active substance is formed during metabolism (see Introduction, Epinephrine, Epinephrine Dipivilate, Dipivefrin).

Hydrolysis of midodrine in the body occurs gradually, and the vasoconstrictor effect develops more slowly and more evenly than with the use of norepinephrine, mezaton, fetanol.

When ingestion, midodrin is well absorbed, is detected in the blood plasma after 10 minutes; the maximum concentration is noted in 2 hours. The half-life is 3 to 4 hours. The drug and its metabolites are excreted mainly by the kidneys.

Medodrin is used for various types of hypotension: for orthostatic hypotension caused by impaired sympathetic nervous system, for idiopathic orthostatic hypotension, secondary hypotension associated with infectious diseases, injuries, and the use of drugs.

Apply midodrin inside and intravenously.

Inside is usually prescribed 1 tablet containing 2, 5 mg 2 (less than 3) times a day or 7 drops of a 1% solution 2 times a day. When a clinical effect is achieved and for long-term therapy, 1/2 tablet (1, 25 mg) is prescribed 2 times a day or 3 drops of a 1% solution 2 times a day. In some cases, first appoint 2 tablets (5 mg), 2 times a day.

Intravenously administered, if necessary, the contents of 1 ampoule (5 mg), 2 times a day.

Treatment with midodrine should be carried out under the control of blood pressure and other hemodynamic parameters. If you exceed the dose or individual hypersensitivity possible hypertensive reaction, bradycardia, increased sweating, pilomotor reaction ("goose skin"), violations (delay and increased urination).

The drug is contraindicated in hypertension, pheochromocytoma, spastic and obliterating diseases of peripheral vessels, thyrotoxicosis, prostate adenoma, angle-closure glaucoma.