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Midodrine: Wikis


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1 : 1 mixture (racemate)
Systematic (IUPAC) name
(RS)- N-[2-(2,5-dimethoxyphenyl)-2-hydroxyethyl]glycinamide
CAS number 133163-28-7
ATC code C01CA17
PubChem 4195
DrugBank APRD01116
Chemical data
Formula C12H18N2O4 
Mol. mass 254.282 g/mol
SMILES eMolecules & PubChem
Synonyms 2-amino-N-[2-(2,5-dimethoxyphenyl)-2-hydroxy-ethyl]-acetamide
Therapeutic considerations
Pregnancy cat.  ?
Legal status
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Midodrine (brand names Amatine, ProAmatine, Gutron) is a vasopressor/antihypotensive agent. It is an odorless, white, crystalline powder, soluble in water and sparingly soluble in methanol.


Mechanism of Action

Midodrine hydrochloride forms an active metabolite, desglyMidodrine, that is an alpha1-agonist, and exerts its actions via activation of the alpha-adrenergic receptors of the arteriolar and venous vasculature, producing an increase in vascular tone and elevation of blood pressure. DesglyMidodrine does not stimulate cardiac beta-adrenergic receptors. DesglyMidodrine diffuses poorly across the blood-brain barrier, and is therefore not associated with effects on the central nervous system.

Metabolite desglymidodrine


After oral administration, midodrine hydrochloride is rapidly absorbed. The plasma levels of the prodrug peak after about half an hour, and decline with a half-life of approximately 25 minutes, while the metabolite reaches peak blood concentrations about 1 to 2 hours after a dose of midodrine and has a half-life of about 3 to 4 hours. The absolute bioavailability of midodrine (measured as desglyMidodrine) is 93%.


Midodrine hydrochloride tablets are indicated for the treatment of symptomatic orthostatic hypotension. It has been suggested also as a treatment for chronic fatigue syndrome. [1]


Midodrine hydrochloride tablets are contraindicated in patients with severe organic heart disease, acute renal disease, urinary retention, pheochromocytoma or thyrotoxicosis. Midodrine hydrochloride should not be used in patients with persistent and excessive supine hypertension.

Side Effects

Headache; feeling of pressure/fullness in the head, vasodilation/flushing face, confusion/thinking abnormality, dry mouth; nervousness/anxiety and rash.


  1. ^ Naschitz J, Dreyfuss D, Yeshurun D, Rosner I (April 2004). "Midodrine treatment for chronic fatigue syndrome". Postgrad Med J 80 (942): 230–2. doi:10.1136/pgmj.2003.011429. PMID 15082846. 

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