Drug interactions
Ephedrine + Midodrine
Severity: Moderate
Ephedrine 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
Ephedrine is an indirect and direct sympathomimetic, and combining it with midodrine can produce additive vasoconstriction and heart rate effects. This may cause excessive hypertension, reflex bradycardia or arrhythmia, especially in patients with cardiovascular disease.
What this interaction means in plain words
Ephedrine 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.
Ephedrine belongs to Cardiovascular; Midodrine belongs to Miscellaneous.
Why it happens
Additive pharmacodynamic sympathomimetic effects on alpha-adrenergic receptors and norepinephrine release.
What to do
Monitor blood pressure and heart rate when both are used, and reduce the dose of one agent if blood pressure rises excessively. Avoid in patients with uncontrolled hypertension or significant cardiac disease.
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 Ephedrine
- Ephedrine + Isocarboxazid Contraindicated
- Ephedrine + Phenelzine Contraindicated
- Ephedrine + Procarbazine Contraindicated
- Ephedrine + Rasagiline Contraindicated
- Ephedrine + Selegiline Contraindicated
- Ephedrine + Tranylcypromine Contraindicated
Frequently asked questions
Can I take Ephedrine with Midodrine?
MediHelp rates the interaction as moderate. Ephedrine 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. Ephedrine is an indirect and direct sympathomimetic, and combining it with midodrine can produce additive vasoconstriction and heart rate effects. This may cause excessive hypertension, reflex bradycardia or arrhythmia, especially in patients with cardiovascular disease.
How serious is the interaction between Ephedrine 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: Monitor blood pressure and heart rate when both are used, and reduce the dose of one agent if blood pressure rises excessively. Avoid in patients with uncontrolled hypertension or significant cardiac disease.
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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