Midodrine hydrochloride in symptomatic orthostatic hypotension: a double-blind, placebo-controlled, randomized, tilt-table study

[Dude]

Over the past few months, my condition has somehow changed. I had a good phase with over 5000 steps daily, but recently I've had to lie down more often, otherwise my symptoms would worsen. It was strange because I had energy, but as soon as I stood up, I became dizzy and nauseous. I suspect that I might have developed something like POTS, which fits the symptoms; also, my blood pressure was always below 70. So, I thought I'd try 2.5 mg of Midodrine and instantly had more energy. I could sit and stand for longer periods again and felt generally better. Unfortunately, this state only lasts about 4 hours, which matches the duration of Midodrine's effect quite closely. Therefore, my question to those who have benefited from it: How much do you take daily? Is this just a temporary solution, or has it helped you permanently?

 

[Donsboig]

@Dude sounds like it could be POTS or orthostatic hypotension, which you probably know are similar and are treated in very similar ways.

Midodrine does last around 4 hours, I feel it wearing off after 3 hours. So I have it prescribed 10mg 4x daily, and I take it roughly every 3.5 hours. It really helps. I've been on it for over 1 year now, just need to keep an eye on blood pressure, especially supine blood pressure, to make sure it doesn't go too high.

I would definitely recommend getting checked out for POTS / OH, or at the very least doing the at home NASA lean test which is very easy to do. I have found the standard POTS drugs (midodrine, fludrocortisone, ivabradine) incredibly helpful for my fatigue, headaches, orthostatic intolerance. They have taken me from mostly housebound to being able to live life a little (carefully!)

 

[Shanti1]

@Dude I have OI without POTs. My miracle med has been Droxidopa. More info in this thread: https://forums.phoenixrising.me/thr...any-words-of-wisdom-regarding-this-med.42680/

Midodrine didn't work for me though, or fludro, or pyridostigmine, or water/salt loading, and other meds were not indicated due to low BP and no elevated heart rate, so thankfully, droxi did.

 

[Donsboig]

@Shanti1 would droxidopa be appropriate to take if blood pressure is normal or slightly elevated? Or is it more for low BP?

 

[Shanti1]

@Donsboig really only for low blood pressure or possible low-normal if lack of blood flow to the brain with symptoms of light-headedness are happening despite normal pressure.

 

[Murph]

For me midodrine has a good effect for about 6h. it also prevents sleep for about 10h. If I have it after 12 noon I can't be asleep before 10. I try to have it first thing in the morning and again at about 11.45am