Midodrine

Midodrine
Above: molecular structure of midodrine Below: 3D representation of a midodrine molecule
Clinical data
Trade namesProamatine, others
Other namesST-1085; TS-701; 3,6-Dimethoxy-β-hydroxy-N-aminoethanonyl-2-phenylethylamine; 2-Amino-N-[2-(2,5-dimethoxyphenyl)-2-hydroxyethyl]acetamide; 1-2',5'-Dimethoxyphenyl-1)-2 glycinamidoethanol
AHFS/Drugs.comMonograph
MedlinePlusa616030
License data
Pregnancy
category
  • AU: C
Routes of
administration
By mouth
Drug classα1-Adrenergic receptor agonist; Antihypotensive agent
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability93% (as desglymidodrine)[1][2]
MetabolismDeglycination[1][2]
Metabolites• Desglymidodrine[1][2]
Onset of action≤1 hour[1]
Elimination half-lifeMidodrine: 0.5 hours[2]
Desglymidodrine: 2–4 hours[2]
Duration of action2–6 hours[1][2]
Identifiers
IUPAC name
  • (RS)-N-[2-(2,5-Dimethoxyphenyl)-2-hydroxyethyl]glycinamide
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.151.349 100.050.842, 100.151.349
Chemical and physical data
FormulaC12H18N2O4
Molar mass254.286 g·mol−1
3D model (JSmol)
ChiralityRacemic mixture
SMILES
  • O=C(NCC(O)c1cc(OC)ccc1OC)CN
  • InChI=1S/C12H18N2O4/c1-17-8-3-4-11(18-2)9(5-8)10(15)7-14-12(16)6-13/h3-5,10,15H,6-7,13H2,1-2H3,(H,14,16) Y
  • Key:PTKSEFOSCHHMPD-UHFFFAOYSA-N Y

Midodrine, sold under the brand name Proamatine among others, is an antihypotensive medication used to treat orthostatic hypotension (low blood pressure when standing) and urinary incontinence.[1] It is taken by mouth.[1]

Side effects of midodrine include hypertension (high blood pressure), paresthesia, itching (pruritus), goose bumps, chills, urinary urgency, urinary retention, and urinary frequency.[1] Midodrine is a prodrug of its active metabolite desglymidodrine.[1] This metabolite acts as a selective agonist of the α1-adrenergic receptor.[1] This in turn results in vasoconstriction and increased blood pressure.[1]

Midodrine was discovered by 1971[3] and was introduced for medical use in the United States in 1996.[4]

  1. ^ a b c d e f g h i j k l "Proamatine- midodrine hydrochloride tablet". DailyMed. Retrieved 14 August 2021.
  2. ^ a b c d e f Gilden JL (2004). "Midodrine and Other Sympathomimetics". Primer on the Autonomic Nervous System. Elsevier. pp. 413–415. doi:10.1016/b978-012589762-4/50113-4. ISBN 978-0-12-589762-4.
  3. ^ Cite error: The named reference Elks2014 was invoked but never defined (see the help page).
  4. ^ Kymes SM, Sullivan C, Jackson K, Raj SR (May 2020). "Real-world droxidopa or midodrine treatment persistence in patients with neurogenic orthostatic hypotension or orthostatic hypotension". Autonomic Neuroscience. 225 102659. doi:10.1016/j.autneu.2020.102659. PMID 32200263.