Drug interactions
Methyldopa + Midodrine
Severity: Moderate
Methyldopa 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
Midodrine is an alpha-1 agonist used to raise blood pressure and directly opposes the effect of methyldopa. Using both can make blood pressure control erratic, with possible supine hypertension.
What this interaction means in plain words
Methyldopa 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.
Methyldopa belongs to Cardiovascular; Midodrine belongs to Miscellaneous.
Why it happens
Pharmacodynamic antagonism between alpha-1 agonism and central sympatholytic antihypertensive action.
What to do
Monitor supine and standing blood pressure and adjust the doses of both agents. Avoid dosing midodrine near bedtime.
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 Methyldopa
- Methyldopa + Tranylcypromine Contraindicated
- Iobenguane i + Methyldopa Major
- Lofexidine + Methyldopa Major
- Methyldopa + Pexidartinib Major
- Methyldopa + Pretomanid Major
- Methyldopa + Thioridazine Major
Other interactions of Midodrine
- Isocarboxazid + Midodrine Contraindicated
- Midodrine + Phenelzine Contraindicated
- Midodrine + Tranylcypromine Contraindicated
- Dextroamphetamine + Midodrine Major
- Dihydroergotamine intranasal + Midodrine Major
- Dihydroergotamine + Midodrine Major
Frequently asked questions
Can I take Methyldopa with Midodrine?
MediHelp rates the interaction as moderate. Methyldopa 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. Midodrine is an alpha-1 agonist used to raise blood pressure and directly opposes the effect of methyldopa. Using both can make blood pressure control erratic, with possible supine hypertension.
How serious is the interaction between Methyldopa 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 supine and standing blood pressure and adjust the doses of both agents. Avoid dosing midodrine near bedtime.
What other medicines interact with Methyldopa?
MediHelp also lists interactions of Methyldopa with, for example, Tranylcypromine, Iobenguane i, Lofexidine. The full list is on the Methyldopa page.
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