Drug interactions
Midodrine + Phenylephrine
Severity: Moderate
Midodrine and Phenylephrine: 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 are alpha-1 agonist vasopressors, so combined use can cause excessive blood pressure elevation. Supine hypertension and reflex bradycardia are particular concerns with midodrine.
What this interaction means in plain words
Midodrine and Phenylephrine 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; Phenylephrine belongs to Respiratory.
Why it happens
Additive alpha-1 adrenergic receptor agonism and vasoconstriction.
What to do
Avoid concurrent use of systemic phenylephrine where possible. If combined, monitor blood pressure including supine readings and heart rate.
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 Phenylephrine
- Isocarboxazid + Phenylephrine Contraindicated
- Phenelzine + Phenylephrine Contraindicated
- Phenylephrine + Tranylcypromine Contraindicated
- Bromocriptine + Phenylephrine Major
- Cocaine + Phenylephrine Major
- Dihydroergotamine intranasal + Phenylephrine 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 Midodrine with Phenylephrine?
MediHelp rates the interaction as moderate. Midodrine and Phenylephrine 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 are alpha-1 agonist vasopressors, so combined use can cause excessive blood pressure elevation. Supine hypertension and reflex bradycardia are particular concerns with midodrine.
How serious is the interaction between Midodrine and Phenylephrine?
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 concurrent use of systemic phenylephrine where possible. If combined, monitor blood pressure including supine readings and heart rate.
What other medicines interact with Phenylephrine?
MediHelp also lists interactions of Phenylephrine with, for example, Isocarboxazid, Phenelzine, Tranylcypromine. The full list is on the Phenylephrine page.
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