Could I easily make my own topical midodrine cream?

[marcjf]

I have midodrine pills (5mg), but do not want to take it orally anymore.
I want to make what this paper is proposing: https://jamanetwork.com/journals/jamadermatology/fullarticle/2290938

"Midodrine, 0.2%, in a moisturizing skin cream (Vanicream) was compounded at the Mayo Clinic pharmacy and applied topically 3 times daily during symptoms. "

Would that be hard to DIY?

 

[sunshine44]

I am a huge fan of transdermal applications. I tolerate much better than orally for many things. Could you try your ratio mixed in some coconut oil? Apply to areas with least amount of hair.

 

[marcjf]

I am a huge fan of transdermal applications. I tolerate much better than orally for many things. Could you try your ratio mixed in some coconut oil? Apply to areas with least amount of hair.

I think you misunderstood the intent of my post. I am wondering how to prepare that ratio in the first place.

 

[Shanti1]

A 0.2% midodrine cream would contain 2mg of midodrine per gram of cream. Following the study dose, if you have 5mg pills, than each one would make 2.5g of cream.

I'm sure the compounding pharmacy added pure midodrine to the vanicream. You have 'pills' (tablets?) that contain excipients. Not sure what the weight of each is but you may want to consider the pill weight as part of the total cream weight.
If you look up its properties, midodrine has decent solubility in water and better in DMSO. I do not believe it is soluble in fat. It is well within the molecular weight that can pass through the skin.
https://go.drugbank.com/salts/DBSALT000250
https://www.selleckchem.com/products/midodrine.html

My thought would be first dissolve the entire pill in as small amount possible of DMSO or DMSO/water mix and then add the well dissolved content to a cream. DMSO has advantages of being a solvent and helping things to cross the skin barrier, but it can be irritating to some peoples skin, so you will have to experiment and make sure to patch test first. Your end product should be 2mg midodrine per g of base (cream).

The study didn't specify how many grams of cream were used with each application. You will want to start with very low amounts and work up since there is no established dosing. Curious if it would provide a more local or systemic effect.

 

[wabi-sabi]

If you have someone who is giving you a prescription for midrodine, why not ask them to send it to a compounding pharmacy to be made topically?

 

[marcjf]

A 0.2% midodrine cream would contain 2mg of midodrine per gram of cream. Following the study dose, if you have 5mg pills, than each one would make 2.5g of cream.

I'm sure the compounding pharmacy added pure midodrine to the vanicream. You have 'pills' (tablets?) that contain excipients. Not sure what the weight of each is but you may want to consider the pill weight as part of the total cream weight.
If you look up its properties, midodrine has decent solubility in water and better in DMSO. I do not believe it is soluble in fat. It is well within the molecular weight that can pass through the skin.
https://go.drugbank.com/salts/DBSALT000250
https://www.selleckchem.com/products/midodrine.html

My thought would be first dissolve the entire pill in as small amount possible of DMSO or DMSO/water mix and then add the well dissolved content to a cream. DMSO has advantages of being a solvent and helping things to cross the skin barrier, but it can be irritating to some peoples skin, so you will have to experiment and make sure to patch test first. Your end product should be 2mg midodrine per g of base (cream).

The study didn't specify how many grams of cream were used with each application. You will want to start with very low amounts and work up since there is no established dosing. Curious if it would provide a more local or systemic effect.

Thank you very much. This is extremely helpful.