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Midodrine Only 2x A Day? Starting At 5mg Each Time?


kitchmill
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My cardiologist prescribed Midodrine for me today at 2x/day, 5mg each dose. I thought that I've read most people take it more often than that, or start with smaller doses and work their way up.

Any thoughts on this? Should I split the pills to start?

Also, he prescribed it INSTEAD of my beta blocker, which was doing just fine to control the vast majority of my episodes. I thought he would add a small amount of Midodrine with the BB to help control the remaining episodes... Starting to wonder if he knows what he's doing.

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Standard dosing of midodrine is once every four hours while upright, with the last dose occurring at least 4 hours before you plan to lay down for bed to avoid supine hypertension. Amount taken at each 4 hour interval can go anywhere from 2.5 mg all the way up to 12.5 (maybe even more depending on the doctor). 5mg is a pretty standard starting dose from what folks have written here on the forum--although for folks very sensitive to meds, 2.5 is just as frequently given.

Can't really say whether or not your doc knows what he/she is doing but 2x a day would be fine *if* you're upright for about 8 hours total each day. For me, 3 doses were the minimum to get through a typical day, and if I had any evening activities after work, 4 doses.

If you don't do well with the med, not to worry, it wears off in 4 hours. I could typically tell you the exact moment b/c my bp would crash and I'd become instantly symptomatic.

Nina

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Thanks for the info, Nina. *If I had an 8 hour day...* HA! I'm thinking that if it works, twice a day wouldn't be enough. I work full time and have 2 active young children, so my time on my feet each day is minimum 15 hours (of course, I have a desk job, but you know what I mean).

And of course, I am really sensitive to meds. Kind of hesitant to start with 5mg. Wondering if I should just try the 10mg daily dose split up over 4 doses instead of 2 to begin with and see how that works. At least I would know that I can still up it to 5mg, and can always call my doc if I am noticing it wear off too early. He wants to see me again in 2 month anyway, but I can call earlier.

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