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Midodrine

Gutron · ATC code C01CA17

Also known as: Midodrin

Key facts
Active substance
Midodrine
Drug class
Butyroxan
ATC code
C01CA17
Authorisation
authorised nationally; no central EU authorisation
Information as of
2026-10-29

Key facts

Midodrine is an alpha-adrenergic agonist. Per the US prescribing information, it is used for symptomatic orthostatic hypotension in patients whose lives are considerably impaired despite standard care.

What it is used for

  • Symptomatic orthostatic hypotension in patients whose lives are considerably impaired despite standard care (e.g. support stockings, fluid expansion, lifestyle changes)
  • Continue only in patients who report significant symptomatic improvement

Dosing

  • 10 mg three times daily during daytime hours when upright: shortly before or upon arising, midday and late afternoon (not later than 6 P.M.)
  • May be given at 3-hour intervals if required, but not more often
  • Not after the evening meal or less than 4 hours before bedtime
  • Abnormal renal function: start with 2.5 mg doses; monitor supine and standing blood pressure regularly

Contraindications

  • Severe organic heart disease, acute renal disease, urinary retention
  • Pheochromocytoma or thyrotoxicosis
  • Persistent and excessive supine hypertension

Important warnings

  • Boxed warning: can cause marked elevation of supine blood pressure; approval is based on a surrogate marker and clinical benefit has not been verified
  • Supine hypertension; stop immediately if it persists; single doses of 20 mg caused severe supine hypertension in about 45%
  • Slight slowing of heart rate; discontinue if signs of bradycardia occur
  • Caution with urinary retention, diabetes and visual problems with fludrocortisone

Side effects

  • Paresthesia 18.3%, piloerection 13.4%, dysuria 13.4%, pruritus (mainly scalp) 12.2%
  • Supine hypertension 7.3%, chills 4.9%, pains 4.9%, rash 2.4%
  • Urinary urge, urinary retention and urinary frequency

Interactions

  • Cardiac glycosides: may enhance or precipitate bradycardia, AV block or arrhythmia
  • Drugs that raise blood pressure (phenylephrine, pseudoephedrine, ephedrine, dihydroergotamine, thyroid hormones, droxidopa): higher risk of hypertension; avoid MAO inhibitors and linezolid
  • Fludrocortisone: monitor for supine hypertension; alpha-blockers (prazosin, terazosin, doxazosin) can antagonize the effect

Pregnancy and breastfeeding

  • No adequate studies in pregnant women; use only if the potential benefit justifies the risk
  • Not known whether excreted in human milk; use caution

Summary of the official product information, written with AI on 2026-10-29. Every number was checked automatically against the original text. Not reviewed by a physician – the full official text is authoritative.

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For patients

Patient information (US)

This product has no separate US patient information.

Authorisation and brand names by country

Medicines with exactly this active-substance composition, as listed in the national registers – alphabetical and without ranking. Whether a product is currently available is not shown here.

Austria

  • GutronCheplapharm Arzneimittel Gmbh · 1 register entry

Source: EMA – Article 57 product data (EU/EEA), as of 2026-10-29

Germany

  • GutronCheplapharm Arzneimittel Gmbh · 1 register entry

Source: EMA – Article 57 product data (EU/EEA), as of 2026-10-29

Brand names in 18 more European countries
Bulgaria
Гутрон
Cyprus
Midodrine Tillomed
Czechia
Gutron
Denmark
Augermid, Hypotron, Midodrin Zentiva, Midodrine Medical Valley, Midodrine Tillomed
Finland
Hypotron, Midodrine Tillomed
France
Gutron, Midodrine Arrow, Midodrine Biogaran, Midodrine Gerda, Midodrine Substipharm, Midodrine Teva, Midodrine Tillomed, Midodrine Viatris, Midodrine Zentiva
Greece
Midodrine Tillomed
Hungary
Gutron
Iceland
Hypotron, Midodrin Evolan, Midodrin Zentiva, Midodrine Hydrochloride Teva
Ireland
Midodrine Hydrochloride Aspire, Midodrine Tillomed, Midon
Italy
Gutron
Netherlands
Gutron, Midodrine Hcl Brancaster
Norway
Augermid, Hypotron, Midodrine Medical Valley, Midodrine Tillomed
Poland
Gutron
Portugal
Gutron
Romania
Gutron
Spain
Gutron
Sweden
Augermid, Hypotron, Midodrin Evolan, Midodrin Zentiva, Midodrine Medical Valley, Midodrine Tillomed

EMA – Article 57 product data (EU/EEA), 2026-10-29

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Sources

  1. U.S. Food and Drug Administration. Midodrine Hydrochloride (Par Health USA, LLC) – Prescribing Information, 2026-08-20. DailyMed (NLM), 2026-10-29. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=863f12bd-d4a9-4547-8667-5dfa9e2ce6d1
  2. EMA – Article 57 product data (EU/EEA), 2026-10-29. https://www.ema.europa.eu/en/human-regulatory-overview/post-authorisation/data-medicines-iso-idmp-standards-post-authorisation/public-data-article-57-database
  3. EMA – Article 57 product data (EU/EEA), 2026-10-29. https://www.ema.europa.eu/en/human-regulatory-overview/post-authorisation/data-medicines-iso-idmp-standards-post-authorisation/public-data-article-57-database
  4. Wikidata (CC0): ATC C01CA.

Editorial: Medelix editorial team · last updated 2026-10-29 · How these pages are made · Report an error

Source: U.S. Food and Drug Administration (FDA), prescribing information, via DailyMed (NLM); public domain. Not advertising, not a treatment recommendation. For questions about your own treatment, ask your doctor or pharmacist.