PAD - Prescribing Advisory Database
PLEASE NOTE : This is a development system.

For Surrey PAD, please go to https://surreyccg.res-systems.net/PAD.

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PAD Profile : Midodrine hydrochloride - Orthostatic hypotension

Keywords :
postural hypotension, low blood pressure, Parkinson's disease
Brand Names Include :
Bramox

Traffic Light Status

Status 1 of 1.

Status :
Blue
Important
Formulations :
  • Tablets
Important Information :
Postural hypotension in Parkinson's disease. Specialist team initiation and supply for at least 1 month before transfer of prescribing to primary care.
Trust Alignment :
Primary Care
ASPH
RSFT
SASH
SABP
Links :
Comments :
No comments returned.
Documents :

Guidelines

No guidelines returned.

Other Drugs

Other Indications

No indications returned.

Additional Documents

Committee Recommendations

Date
Committee Name
Narrative
06 June 2018
Surrey & North West Sussex Area Prescribing Committee (formerly Prescribing Clinical Network)

Midodrine may be considered (2nd line after fludrocortisone) for the treatment of orthostatic hypotension
- due to autonomic dysfunction;  OR
- in patients with Parkinson's Disease
See the Midodrine SPC for details of contraindications and monitoring requirements and information sheet

Midorine should only be initiated on request from a Parkinson's specialist and only after a review of existing medicines to address any potential pharmalogical causes for the hypotension (including antihypertensives, dopaminergics, anticholinergics, antidepressants).

Fludrocortisone, although unlicensed for this use, should be used in preference to midodrine . Again, refer to the SPC for clinical particulars including contraindications and interactions with other medicines

01 June 2016
Surrey & North West Sussex Area Prescribing Committee (formerly Prescribing Clinical Network)
The PCN recommends midodrine (Bramox®) as a treatment option, after fludrocortisone, for the treatment of orthostatic hypotension due to autonomic dysfunction. A prescribing information sheet is available below. Midodrine (Bramox) for orthostatic hypotension was assigned a BLUE traffic light status (formerly Amber*). As such, it was agreed as appropriate for primary care prescribing AFTER initiation by a specialist.

Associated BNF Codes

02. Cardiovascular System
02.07.02. Vasoconstrictor sympathomimetics
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