Authors' objectives: Midodrine (Bramox) is intended to be used as a treatment option for patients with severe orthostatic hypotension. It is licensed in the UK for the treatment of orthostatic hypotension due to autonomic dysfunction when corrective factors have been ruled out and other (non-pharmacological) forms of treatment are inadequate. Midodrine is a peripheral α-adrenergic agonist that is almost completely absorbed after oral administration and undergoes enzymatic hydrolysis to form its pharmacologically active metabolite, de-gly-midodrine. Orthostatic hypotension (or postural hypotension) is a condition in which standing leads to an abnormally large drop in blood pressure that can result in symptoms such as light-headedness, dizziness, blurring of vision, fainting and falls. Orthostatic hypotension is more common in older people, and estimates of prevalence range from 5% to 30% of people aged over 65 years (in the general population), up to 60% of people with Parkinson's disease and up to 70% of people living in nursing homes. A number of pharmacological and non-pharmacological approaches have been used to treat postural hypotension. Non-pharmacological treatments include increasing water and salt intake, or using compression garments or bandages and physical manoeuvres to counter the drop in blood pressure. Midodrine has recently been licensed in the UK for the treatment of this condition, and a number of drugs have been used off-label to manage orthostatic hypotension. Midodrine has completed a number of trials comparing its effect on standing and supine blood pressure with those of placebo and ephedrine.

Project Status: Completed

Year Published: 2015

URL for published report: http://www.hsric.nihr.ac.uk/topics/midodrine-bramox-for-orthostatic-hypotension/

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England, United Kingdom

Organisation Name: NIHR Horizon Scanning Centre

Contact Address: The NIHR Horizon Scanning Centre, Department of Public Health, Epidemiology, and Biostatistics, School of Health and Population Sciences, University of Birmingham, 90 Vincent Drive, Edgbaston, Birmingham, B15 2SP. United Kingdom. Tel: +44 121 414 7831, Fax: +44 121 2269

Contact Name: c.packer@bham.ac.uk

Contact Email: c.packer@bham.ac.uk

Copyright: NIHR Horizon Scanning Research&Intelligence Centre (NIHR HSRIC)