Drug interactions
Droxidopa + Midodrine
Severity: Moderate
Droxidopa and Midodrine: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both drugs raise blood pressure through adrenergic mechanisms and are used for orthostatic hypotension. Together they can produce additive pressor effects, increasing the risk of supine hypertension, which is a labeled warning for each drug.
What this interaction means in plain words
Droxidopa and Midodrine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Droxidopa belongs to Cardiovascular; Midodrine belongs to Miscellaneous.
Why it happens
Additive pressor effects: midodrine is a direct alpha-1 agonist and droxidopa is converted to norepinephrine.
What to do
Avoid routine combination where possible; if used, monitor supine and standing blood pressure and keep the head of the bed elevated. Avoid dosing close to bedtime and reduce doses if supine hypertension occurs.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Midodrine
- Isocarboxazid + Midodrine Contraindicated
- Midodrine + Phenelzine Contraindicated
- Midodrine + Tranylcypromine Contraindicated
- Dextroamphetamine + Midodrine Major
- Dihydroergotamine intranasal + Midodrine Major
- Dihydroergotamine + Midodrine Major
Other interactions of Droxidopa
- Droxidopa + Lisdexamfetamine Major
- Droxidopa + Methamphetamine Major
- Droxidopa + Pseudoephedrine Major
- Adrenaline-articaine + Droxidopa Moderate
- Almotriptan + Droxidopa Moderate
- Caffeine + Droxidopa Moderate
Frequently asked questions
Can I take Droxidopa with Midodrine?
MediHelp rates the interaction as moderate. Droxidopa and Midodrine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Both drugs raise blood pressure through adrenergic mechanisms and are used for orthostatic hypotension. Together they can produce additive pressor effects, increasing the risk of supine hypertension, which is a labeled warning for each drug.
How serious is the interaction between Droxidopa and Midodrine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid routine combination where possible; if used, monitor supine and standing blood pressure and keep the head of the bed elevated. Avoid dosing close to bedtime and reduce doses if supine hypertension occurs.
What other medicines interact with Midodrine?
MediHelp also lists interactions of Midodrine with, for example, Isocarboxazid, Phenelzine, Tranylcypromine. The full list is on the Midodrine page.
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