Drug interactions
Midodrine + Olanzapine
Severity: Moderate
Midodrine and Olanzapine: 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
Olanzapine can cause orthostatic hypotension through alpha-1 blockade, which directly opposes the pressor effect of midodrine. The antipsychotic may reduce midodrine's benefit in patients treated for orthostatic hypotension.
What this interaction means in plain words
Midodrine and Olanzapine 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 belongs to Miscellaneous; Olanzapine belongs to Central Nervous System.
Why it happens
Pharmacodynamic antagonism between olanzapine's alpha-1 adrenergic blockade and midodrine's alpha-1 agonism.
What to do
Monitor supine and standing blood pressure and adjust midodrine if the response is inadequate. Consider an antipsychotic with less alpha-1 blockade if hypotension persists.
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 Olanzapine
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 Midodrine with Olanzapine?
MediHelp rates the interaction as moderate. Midodrine and Olanzapine 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. Olanzapine can cause orthostatic hypotension through alpha-1 blockade, which directly opposes the pressor effect of midodrine. The antipsychotic may reduce midodrine's benefit in patients treated for orthostatic hypotension.
How serious is the interaction between Midodrine and Olanzapine?
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 midodrine if the response is inadequate. Consider an antipsychotic with less alpha-1 blockade if hypotension persists.
What other medicines interact with Olanzapine?
MediHelp also lists interactions of Olanzapine with, for example, Amisulpride, Amoxapine, Apomorphine. The full list is on the Olanzapine page.
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