Surrey Heartlands

Joint Formulary & PAD

Midodrine hydrochloride - Orthostatic hypotension

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Status 1

Blue
Formulations :
  • Tablets
Formulary Status :
Primary Care
ASPH
RSFT
SASH
SABP
Associated Icons :
BNF SPC
Restrictions / Comments :
Important
Postural hypotension in Parkinson's disease. Specialist team initiation and supply for at least 1 month before transfer of prescribing to primary care.

Documentation

Guidelines (National)
NICE NG71 Parkinsons-disease-in-adults
Shared Care
Midodrine for Orthostatic Hypotension - Blue Information Sheet - May 2017
Shared Care
RSCH - Midodrine for Orthostatic Hypotension - Blue Information Sheet - May 2017
Evidence Review
Midodrine for orthostatic hypotension - Evidence review - Apr 2016

PAD Profile

ChemicalSubstance :
Midodrine hydrochloride
Indication :
Orthostatic hypotension
Group Name :
Keywords :
postural hypotension, low blood pressure, Parkinson's disease, diabetic neuropathy
Brand Names Include :
Bramox
Important Information :
Latest Additions Date From :
Latest Additions Date To :
Guidelines :
Supporting Documents :
4

Other Indications

Below are listed other indications that Midodrine hydrochloride is used to treat.

  • No records returned.

Other Drugs

Below are listed other drugs that are used to treat Orthostatic hypotension.

Committee Recommendations (2)

06 Jun 18 - Surrey & North West Sussex Area Prescribing Committee (formerly Prescribing Clinical Network)

Midodrine may be considered (2nd line after fludrocortisone) for the treatment of orthostatic hypotension
- due to autonomic dysfunction;  OR
- in patients with Parkinson's Disease
See the Midodrine SPC for details of contraindications and monitoring requirements and information sheet

Midorine should only be initiated on request from a Parkinson's specialist and only after a review of existing medicines to address any potential pharmalogical causes for the hypotension (including antihypertensives, dopaminergics, anticholinergics, antidepressants).

Fludrocortisone, although unlicensed for this use, should be used in preference to midodrine . Again, refer to the SPC for clinical particulars including contraindications and interactions with other medicines

01 Jun 16 - Surrey & North West Sussex Area Prescribing Committee (formerly Prescribing Clinical Network)
The PCN recommends midodrine (Bramox®) as a treatment option, after fludrocortisone, for the treatment of orthostatic hypotension due to autonomic dysfunction.
A prescribing information sheet is available below.
Midodrine (Bramox) for orthostatic hypotension was assigned a BLUE traffic light status (formerly Amber*). As such, it was agreed as appropriate for primary care prescribing AFTER initiation by a specialist.