Pharmacy Guide
Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
Pharmacy Guide
Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
Midodrine 2.5 Tablets
⚠ This medicine appears to have been discontinued
The electronic medicines compendium (emc) no longer publishes a Summary of Product Characteristics for this product, which usually means it is no longer marketed in the UK. The patient leaflet below is kept for reference, but the product may not be available.
If you were prescribed this medicine, other products containing Midodrine hydrochloride may still be available. Do not stop your treatment — ask your pharmacist or GP what to use instead.
What it is and what it is used for
for
Midodrine contain the active ingredient midodrine hydrochloride, which acts on the blood vessels via the sympathetic nervous system to correct imbalances of blood distribution, such as preventing too much blood pooling in the legs when standing up. Midodrine Tablets are used to stop the fall in your blood pressure as a result of your sympathetic nervous system not working correctly. This should help to relieve the symptoms which you might be suffering such as dizziness, fainting, blurred vision and weakness when you sit or stand up. 2.
What you need to know before you take it
e Midodrine
Do not take Midodrine:
- if you are allergic to midodrine hydrochloride or any of the other ingredients of this medicine (listed in section 6);
- if you have tumour near the kidney, known as phaeochromocytoma;
- if you have elevated eye pressure (narrow angle glaucoma);
- if you have thryoid gland problems called thyrotoxicosis or hyperthyroidism i.e. overactive thyroid;
- if you suffer from high blood pressure or a form of low blood pressure known as vasovagal hypotension;
- if you have some types of heart or blood vessel disease;
- if you have inflammation of the kidneys, kidney disease, poor kidney function or if you are having problems passing urine
- if you have damage to the retina in your eye as a result of diabetes (known as proliferative diabetic retinopathy) Men only: if you have an enlarged prostate that causes problems emptying your bladder.
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Warnings and precautions Talk to your doctor or pharmacist before taking Midodrine if you have:
- any kidney problems
- had a stroke in the past or been told that you are at risk of a stroke
- any heart problems Your blood pressure will be monitored before starting, and during, treatment. If you experience any chest pain, palpitations, shortness of breath, headache, blurred vision, pulse slowing, increased dizziness or faintness during treatment, STOP taking the product and seek medical help immediately. Taking Midodrine with other medicines Please tell your doctor if you taking, or have recently taken any other medicines, including medicines obtained without a prescription. This includes herbal medicines. Particularly if you are taking:
- high blood pressure medicines e.g. alpha blockers or beta blockers
- glycosides to increase the force of your heartbeat e.g. digitalis
- tricyclic antidepressants for depression or monoamine oxidase inhibitors (MAOIs)
- amiodarone (used to control heart arrhythmias). Midodrine may increase the effect of this medicine
- metoclopramide (used to stop you feeling and being sick). Midodrine may increase the effect of this medicine
- phenothiazines and atypical antipsychotics for schizophrenia or psychosis
- antihistamines (medicines to treat allergies)
- appetite suppressants
- nasal/ sinus congestion relievers, especially those purchased without a prescription
- thyroid hormones
- steroids (e.g. fludrocortisone). In combination with Midodrine, steroids may increase the risk of eye problems or a high blood pressure whilst lying down. (These medicines are sometimes used together with Midodrine, and your doctor may have prescribed this combination for you)
- Ergot alkaloid, medicines used to treat migraines and Parkinsons. Taking Midodrine with food and drink You can take these tablets with or without food. Pregnancy and breastfeeding If you are pregnant, think you may be pregnant, planning to have a baby or are breastfeeding, ask your doctor or pharmacist for advice before taking this medicine. As safe use during pregnancy has not been established, Midodrine is not recommended. If you become pregnant whilst being treated with Midodrine, you must stop taking this medicine immediately. Midodrine is not recommended during breastfeeding unless advised to by a doctor. Driving and using machinery Midodrine may make you feel dizzy or drowsy. If this happens to you, do not drive a vehicle or operate any tools or machinery during treatment. Important information about some of the ingredients of Midodrine 5 mg tablets Midodrine 5 mg tablets contain Sunset yellow (E110), which may cause allergic reactions. 3.
How to take it
Midodrine
Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure. –
Swallow the tablet whole with water Midodrine can be taken with meals 3
–
You should take your last dose of Midodrine at least four hours before bedtime. This is because Midodrine can cause high blood pressure if you are lying down for any period of time (e.g. sleeping) The tablet can be divided into equal doses.
Adults and the Elderly The usual starting dose is 2.5 mg taken 2 to 3 times daily. Your doctor may increase this dose each week until the best effect is seen. The maximum daily dose is 30 mg. Children Do not give this medicine to children under the age of 18 because the safety and efficacy has not been established. Patients with renal disorders Midodrine should not be administered in patients with severe kidney disorders. Patients with hepatic impairment If you have liver problems, you should consult your doctor. The safety of Midodrine in patients with liver problems has not been established. If you take more tablets than you should If you have taken more Midodrine tablets than you should, contact your doctor immediately or go to your nearest hospital accident and emergency department. Take this leaflet with you. Symptoms of overdose include: high blood pressure, feeling cold, urgent desire to urinate, slow heartbeat and "goose bumps". If you forget to take Midodrine If you forget to take a dose, take your next dose at the usual time and then keep taking your medicine as told by your doctor. Do not take a double dose to make up for a missed dose. If you stop taking Midodrine Do not stop taking these tablets without talking to your doctor first. Contact your doctor or pharmacist if you have any further questions on the use of this medicinal product. 4.
Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them. STOP taking Midodrine and seek medical advice immediately if you experience any of the following signs of an allergic reaction: –
difficulty breathing or swallowing swelling of the face, lips, tongue or throat severe itching of the skin, with a red rash or raised bumps.
The following side effects may occur: Very common: may affect more than 1 in 10 people: goose bumps difficulty/pain in urination Common: may affect up to 1 in 10 people: tingling sensation of the skin ("pins and needles") rash, itching (particularly of the scalp) chills flushing high blood pressure when lying down at daily doses of more than 30 mg (this might cause 4
–
headaches, blurred vision, a 'pounding' heartbeat, chest pain or shortness of breath) nausea, vomiting, indigestion, sore mouth inflammation of mucous membrane inability to pass urine
Uncommon: may affect up to 1 in 100 people: insomnia and problems in sleeping headaches, restlessness, irritability, excitability slowing of pulse high blood pressure when lying down at daily doses of up to 7.5 mg stomach pain sudden urge to urinate Rare: may affect up to 1 in 1000 people: dizziness or lightheadedness visual disturbances fast or irregular heartbeat, chest pain stroke increased liver enzymes (detected in blood test) Not known (frequency cannot be estimated from the available data): anxiety confusion increased tear production diarrhoea Midodrine can cause high blood pressure whilst lying down, particularly if the last dose of the day is taken too close to bedtime. This might cause headaches, blurred vision, a "pounding" heartbeat, chest pain or shortness of breath. If these occur when you lie down or go to bed, tell your doctor. This is very important as, rarely, strokes have occurred. If you are using Midodrine in combination with other medicines that raise blood pressure e.g. fludrocortisone, and you find that your eyes are hurting, you experience visual disturbances (blurred vision) or you have a headache, especially behind the eye, you should tell your doctor. Reporting of side effects If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects, you can help provide more information on the safety of this medicine. 5. 6.
How to store it
Midodrine Keep this medicine out of the sight and reach of children. For HDPE bottle pack: This medicinal product does not require any special storage condition. For blister pack: Store below 250C Do not use this medicine after the expiry date which is stated on the carton and the blister after EXP. The expiry date refers to the last day of that month. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
Contents of the pack and other information
What Midodrine contains The active substance is Midodrine hydrochloride. Each tablet contains 2.5 mg or 5mg Midodrine hydrochloride. The other ingredients are: 5
For both tablets: Hydrophobic colloidal anhydrous silica Microcrystalline cellulose Pregelatinized starch Magnesium stearate For Midodrine 5 mg tablets only: Sunset yellow FCF-Lake (E110) What Midodrine looks like and contents of the pack Midodrine 2.5mg tablets are white to off-white, round, scored tablets debossed with 'H' above the score and 'P' below the score on one side and '504' on the other side. The diameter of the tablet is 7.10 mm ±0.2 mm. The tablets are available in pack sizes containing 30 x 1, 90 x 1 and 100 x 1 tablets in PVC/PVDC/Aluminium and OPA/Alu/PVC/Alu perforated unit dose blisters. They are also available in High Density Polyethylene (HDPE) bottle pack with 100 tablets. Midodrine 5 mg tablets are light orange coloured, round, scored tablets debossed with 'H' above the score and 'P' below the score on one side and '505' on the other side. The diameter of the tablet is 7.10 mm ±0.2 mm. The tablets are available in pack sizes containing 100 x 1 tablets in PVC/PVDC/Aluminium and OPA/Alu/PVC/Alu perforated unit dose blisters. They are also available in High Density Polyethylene (HDPE) bottle pack with 100 tablets. Not all pack sizes may be marketed. Marketing Authorisation Holder and Manufacturer Tillomed Laboratories Limited 220 Butterfield, Great Marlings Luton, LU2 8DL United Kingdom This leaflet was last revised in 09/2025
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Frequently asked questions about Midodrine 2.5 Tablets
How do I take Midodrine 2.5 Tablets?
Midodrine 2.5 Tablets comes as tablet. Always follow the dose your doctor or pharmacist has given you, and read the leaflet that comes with the medicine.
What is the active substance in Midodrine 2.5 Tablets?
The active substance in Midodrine 2.5 Tablets is midodrine hydrochloride.
Where does this information come from?
This leaflet reproduces the patient information leaflet approved for Midodrine 2.5 Tablets, as published on the electronic medicines compendium (emc). The version printed inside your medicine’s packaging is the one that applies to you.
Can I get Midodrine 2.5 Tablets without a prescription?
Whether a medicine is available over the counter or on prescription only depends on its licence. Check the leaflet, or ask your pharmacist — they can tell you straight away.
About this leaflet
The text above reproduces the patient information leaflet approved for this medicine, restructured for easier reading.
- Source: electronic medicines compendium (emc), Datapharm
- Active substance: midodrine hydrochloride
- Official document: view the original leaflet on emc →
⚕For healthcare professionals — Summary of Product Characteristics (SmPC)Full SmPC: dosage, interactions, contraindications, warnings+
4.1. Therapeutic indications
For use in the treatment of severe orthostatic hypotension due to dysfunction of the autonomic nervous system when corrective factors have been ruled out.
4.2. Posology and method of administration
Posology:
Adults:
The usual starting dose is 2.5 mg of midodrine hydrochloride 2-3 times daily. The dose should be increased at weekly intervals in small increments until an optimal response is obtained. Most patients are controlled at or below 30 mg daily given in divided doses. The maximum daily dose is 30 mg midodrine hydrochloride, given in divided doses. Doses in excess of 30 mg daily are not recommended.
The supine and standing blood pressure should be regularly monitored during initial treatment (at least twice a week). And the use of Midodrine should be stopped if supine hypertension is increases excessively. Dosing of Midodrine should occur during the daytime when the patient needs to be in an upright position. A dosing schedule of 3-4 hour intervals is suggested. The last dose should be taken at least four hours before bedtime to reduce the risk of supine hypertension.
Special populations
Elderly
Although there is no evidence to suggest that dosage requirements are different in the elderly, it is recommended that the initial dose used be small and that increases in dosage be titrated against the patients' clinical condition with caution.
The administration of midodrine should be stopped and the attending physician notified immediately if the blood pressure in either position increases above 180/100 mm Hg or is considered clinically significant.
Paediatric population
Not recommended for children.
Patients with renal impairment
No specific studies addressing a possible dose-reduction have been performed in patients with renal insufficiency. Midodrine is contraindicated in patients with acute renal disease and severe renal insufficiency (see section 4.3).
Patients with hepatic impairment
No specific studies have been performed in this patient population.
Method of administration:
Midodrine tablets should be taken with a sufficient amount of fluid. They can be taken during meal times.
4.3. Contraindications
• Hypersensitivity to the active substance or to any of the excipients listed in section 6.1
• Hypertension
• Severe organic heart disease or congestive heart failure
• Thyrotoxicosis
• Pheochromocytoma
• Acute nephritis
• Acute renal disease
• Severe renal insufficiency (creatinine clearance <30 ml/min)
• Hypertrophy of the prostate gland with residual urine volume increased
• Proliferative diabetic retinopathy
• Urinary retention
• Hyperthyroidism
• Narrow angle glaucoma
• Obliterative or spastic vessel disease (e.g. cerebrovascular occlusions and spasms)
• Vasovagal hypotension
4.4. Special warnings and precautions for use
Regular monitoring of blood pressure in supine and sitting position is required during treatment with midodrine. The potential for supine and sitting hypertension should be evaluated at the beginning of midodrine therapy. Patients with diabetes mellitus who show high blood pressure levels in supine position due to underlying neurological disorders (diabetic autonomic neuropathy) may suffer from supine hypertension with midodrine. Hence, caution is recommended.
The patients should be cautioned to report any symptoms of supine hypertension immediately such as cardiac awareness (palpitations, chest pain and shortness of breath), headache, blurred vision etc, and the patient should be advised to discontinue the medication immediately. Patients with a history of cerebrovascular accidents (CVA) or known risk factors for CVA should be monitored closely. The supine hypertension may often be controlled by an adjustment in the midodrine dosage. Supine hypertension may also be controlled by elevation of the head. The treatment should not be continued in patients suffering from severely fluctuating blood pressure with midodrine tablets.
Patients taking midodrine should avoid concomitant use of other adreno- sympathomimetic drugs including over the counter remedies (see 4.5).
Great caution should be exercised in patients with mild to moderate renal insufficiency (creatinine clearance >30ml/min and <90ml/min).
Patients with persistent labile blood pressure after stabilisation on midodrine should discontinue treatment.
Slowing of the heart rate may occur after administration of midodrine, primarily due to vagal reflex, therefore great caution should be taken when using it together with other agents that directly or indirectly slow the heart rate (see also section 4.5) e.g. digitalis, beta blockers, psychopharmacologic agents (specifically tricyclic antidepressants, phenothiazines and atypical antipsychotics). Patients experiencing any signs or symptoms suggestive of bradycardia (pulse slowing, increased dizziness, syncope, cardiac awareness) should be advised to discontinue midodrine.
The use of midodrine in patients who have an increased risk of or suffer from glaucoma / increased intra-ocular pressure or who are treated with mineralocorticoids / fludrocortisone acetate (which may increase intra-ocular pressure) should be avoided or monitored very closely.
It is advisable to monitor the renal function and blood pressure in patients undergoing long-term treatment with midodrine.
Sufficient data is not available for patients with hepatic impairment. Therefore, it is recommended to monitor the liver function before and during treatment with midodrine.
4.5. Interaction with other medicinal products and other forms of interaction
Midodrine is an inhibitor of cytochrome P450 CYP2D6 and may therefore affect the metabolism of other medicines which are metabolised by this isoenzyme (e.g. perphenazine, amiodarone, metoclopramide). This may lead to increased systemic exposure and increased effects of these medicines.
Sympathomimetic medicines and other vasopressor agents
The concomitant use of midodrine with vasoconstrictor, sympathomimetic pressor agents e.g. decongestants, some appetite suppressants and other drugs which cause hypertension such as methyldopa, tricyclic antidepressants, antihistamines, thyroid hormones, MAO-inhibitors including over-the-counter remedies should be avoided as this may cause excessive hypertension.
Alpha and beta receptor blockers
The effects of Midodrine may be antagonised by alpha receptor blockers such as prazosin and phentolamine. The cardiac frequency reducing effect of beta blockers can be potentiated by midodrine.
The concomitant use of alpha- and beta- receptor blocking agents (which reduce the heart rate) and midodrine requires careful monitoring.
Cardiac glycosides
Great caution should be taken when administering midodrine to patients experiencing bradycardia produced by digitalis (or other glycosides) or psychopharmaceutical drugs since midodrine may potentiate reflex bradycardia and other kinds of conduction disorders or arrhythmias.
Ergot alkaloid
Deterioration of peripheral blood circulation.
The patient may experience an increase in blood pressure and reduced blood flow to organs and hands/feet.
Avoid concomitant use of drugs that increase blood pressure. If concomitant use cannot be avoided, the blood pressure is to be monitored closely.
Corticosteroid preparations
Patients being treated with midodrine in combination with, mineralocorticoids or glucocorticoids (e.g. fludrocortisone) may be at increased risk of glaucoma/increased intraocular pressure, and should be carefully monitored. Midodrine may enhance or potentiate the possible hypertensive effect of corticosteroid preparations.
4.6. Fertility, pregnancy and lactation
Pregnancy
There are no data from the use of midodrine in pregnant women. Animal studies have shown reproductive toxicity (see section 5.3).
Midodrine is not recommended during pregnancy and in women of childbearing potential not using contraception. Any woman becoming pregnant during treatment should be withdrawn from the treatment immediately upon established pregnancy.
Breast-feeding
It is unknown whether midodrine/metabolites are excreted in breast milk. A risk to the newborns/infants cannot be excluded. Midodrine should not be used during breast-feeding.
4.7. Effects on ability to drive and use machines
Patients who experience dizziness or light headedness while receiving Midodrine should refrain from operating machinery.
4.8. Undesirable effects
The following frequency categories are used for the evaluation of side-effects:
Very common
Common
Uncommon
Rare
Very rare
Not known
(≥ 1/10)
(≥ 1/100 to < 1/10)
(≥ 1/1000 to < 1/100)
(≥ 1/10000 to < 1/1000)
(< 1/10000)
frequency cannot be estimated based on the available data
System organ class
Very common
Common
Uncommon
Rare
Very rare
Unknown
Psychiatric disorders
Sleep disorders, insomnia
Anxiety, confusional state
Nervous system disorders
Paraesthesia
Headaches, restlessness, excitability, irritation
Dizziness or light headedness
Eye disorders
Visual disturbance
Increased tear production
Cardiac disorders
Reflex bradycardia
Tachycardia, palpitations, arrhythmias, chest pain
Vascular disorders
Supine hypertension (blood pressure above or equal to 180/110 mmHg) with daily doses above 30 mg
Supine hypertension (blood pressure above or equal to 180/110 mmHg) with daily doses up to 7.5 mg
Cerebrovascular accident
Gastrointestinal disorders
Nausea, vomiting, stomatitis dyspepsia
Abdominal pain
Diarrhoea
Hepatobiliary disorders
Hepatic function abnormal, increased liver enzymes
Skin and subcutaneous tissue disorders
Piloerection (goose bumps)
Chills, skin rash, pruritus (mainly of the scalp), flushing
Renal and urinary disorders
Dysuria
Urinary retention
Urinary urgency
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continuous monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
4.9. Overdose
Overdosage of midodrine produces piloerection, sensation of coldness, an urgent desire to empty the bladder, hypertension and bradycardia.
These effects can be counteracted by induced emesis and administration of alpha- sympatholytic drugs. In marked bradycardia, atropine may be given at its usual dose. In exanthema, H-1 antihistamines should be administered.
The active metabolite desglymidodrine is dialysable.
🇷🇴 Known in Romania as
Medicines sold in Romania with the same active substance: Cunoscut în România ca
- GUTRON 2,5 mg prescriptionMIDODRINUM · taken by mouth
Same active substance. The strength, the form and whether you need a prescription can differ. Always ask a pharmacist before you switch. Romanian medicines in the UK →
🇵🇱 Known in Poland as
Medicines sold in Poland with the same active substance: W Polsce znany jako
- GutronMidodrini hydrochloridum · taken by mouth
Same active substance. The strength, the form and whether you need a prescription can differ. Always ask a pharmacist before you switch. Polish medicines in the UK →
💬 Ask about this leaflet
Ask anything about Midodrine 2.5 Tablets. The assistant answers only from this leaflet — if the leaflet does not cover it, it will say so. It does not give medical advice.
Answers come from the patient leaflet published on the electronic medicines compendium (emc). They are not medical advice. Ask a pharmacist or your GP if you are unsure. For urgent help call NHS 111, or 999 in an emergency.