Drug interactions
Midodrine + Procainamide
Severity: Moderate
Midodrine and Procainamide: 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's active metabolite desglymidodrine is a basic compound secreted by renal tubular cation transport, and procainamide and its metabolite NAPA share this route. Competition could reduce procainamide clearance and raise its levels, with a risk of proarrhythmia or QT prolongation.
What this interaction means in plain words
Midodrine and Procainamide 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.
Why it happens
Competition for renal tubular secretion via organic cation transporters.
What to do
Monitor ECG and procainamide and NAPA concentrations when starting or stopping midodrine. Adjust procainamide dose as needed, especially in renal impairment.
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
Frequently asked questions
Can I take Midodrine with Procainamide?
MediHelp rates the interaction as moderate. Midodrine and Procainamide 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's active metabolite desglymidodrine is a basic compound secreted by renal tubular cation transport, and procainamide and its metabolite NAPA share this route. Competition could reduce procainamide clearance and raise its levels, with a risk of proarrhythmia or QT prolongation.
How serious is the interaction between Midodrine and Procainamide?
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 ECG and procainamide and NAPA concentrations when starting or stopping midodrine. Adjust procainamide dose as needed, especially in renal impairment.
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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