Midodrine And Slowed Heartrate

[mkoven]

Hi,

Just saw my ans doc, and she wants to up my intake of midodrine, and take it more often-- 5mgs on arising (530), 5 mgs at 1030, 5 mgs at lunch (to avoid the post meal crash), 2.5 mgs at 330, 5 mgs at dinner, and 2.5 before bed, to avoid the crashes I have when I get up at night. A grand total of 25 mgs a day.

This is my first day on the new schedule. the one thing I notice is that my pulse is slower. I don't think it's a problem-- upper 50s, lower 60s, just a good ten beats slower than normal for me. My bp is a tiny bit higher than normal, but still low-normal. Lying down, still low-normal.

Any cause for concern about the slower hr?

thanks!

Michele

[DADofPotsSon]

Son#2 has similar dosage as you and has near the same results. Dr Grubb has switched him to proamatine instead of the generic midodrine and this works much better. He is also approved to take up to 40 mgs/day for those long college days, midterms, and final exams. His resting HR is usually 50-55 and the BP is always low but with proamatine it is much more stable.

DADofPotsSon

[mandasmom]

They couldn't up my dosage. My HR was dropping into low 30's.

[iheartcats]

You take it before bed? I'm not on it yet, but I've read about it and it says you can't lay down after taking it. Is that true?

Also - I see some of you say it lowers you BP. I thought it would raise it.

I'm apprehensive about going on medication (obviously) but am going to have to. It's interesting to see how it effects people so differently.

[Rachel]

Cat Lady,

Midodrine can raise blood pressure in some people. Warnings in pharmacy papers generally say to avoid lying down while on midodrine/proamatine, but I've read that it is actually less than 10% of people who get high blood pressure from midodrine while lying down. If you have a bp cuff at home you can check your bp to make sure that it isn't going too high.

Midodrine has relatively few side effects. You can read about it at www.rxlist.com. RxList has a wealth of information on prescription drugs.

Rachel

[mkoven]

My doctor says that there is a profile of people who develop supine hypertension, and most of the people on this board don't fit. I've checked repeatedly, and it doesn't cause my bp to spike lying down.

My main complaint is that is is very short-acting and not quite as effective as I'd like.

[flop]

When I take my midodrine my BP goes up. I can lie down after midodrine without getting problems from high BP. I don't find that midodrine causes my resting HR to go lower, but it does reduce the extent of my tachycardia - presumably because my heart isn't fighting quite so much to maintain my BP when I am upright?

Flop

[masumeh]

sorry I'm hopping into this discussion late...

The warnings on ProAm talk about supine hypertension (spiked bp, shouldn't take then lay down), but I asked my cardiologist/POTS specialist about that, and he said that is true for Parkinsons patients not POTS patients. No worries; take and go to bed.

But I did have several problem periods with Midodrine. Just like some of you said, it lowered my HR. I started out on 40mg/day and that really improved my overall symptoms (although it had its own side effects). After a few months, I started to have long fainting spells associated with bradycardia (which I always had intermittently before, but did not faint from it)....would be out for 3 hours at least, like a small comma I guess. With my doctor's guidance, I slashed the meds down to half doses (I was ONLY taking Midodrine, by the way). That worked...for some months, then it started again, and I again slashed the dose in half. So I'm down to 2.5 mg a few times a day.

Also, time is sensitive for me. I cannot take Midodrine early in the day or late at night. Earliest safe dose is like 8AM, latest like 7:30/8PM. If I break this habit, I start to get the brady episodes. I read on a Midodrine drug site that some people might be time sensitive the to drug, although the manufacturers/developers themselves aren't sure why.

[Megan]

Not sure about most of this, but I thought I'd throw in that being on proamatine as opposed to Midodrine helped me.

Meg

[starry16]

Definitely made my HR go down quite a bit. Resting is frequently in low 50's (and at night in mid to high 40's) when before it was high 60's. I'm on 7.5 mg. It doens't seem to do anything to my BP.

[helen.t]

Hi, My heartrate is definately a lot slower on Midodrine and my bp stays low lying down but it can be still quite high when up and about especially if I have to sit up for any length of time. I get funny unpleasant feelings in my head if I lie down after a dose of it as well as my body being very jerky and unsettled. I have to decide in advance if I can keep going to take my afternoon dose or miss it and have a lie down so that I can function better later on. I suffer from migraines a lot and sometimes I have not long taken my midodrine then need a lie down... very frustrating to get it right! Sometimes the slowed heartrate gives me feelings of missing a beat which can be quite unpleasant at times but I still feel better on midodrine than not. Helen

[wireless]

My dys specialist warned me not to lie down after my 5 mg doses.

In papers, Dr Low et al wrote that at a 5 mg dose there's not supine hypertension risk though. If it were frequent doses then I think the risk goes up, he was talking about 3x a day I believe.