Drug interactions
Midodrine + Pseudoephedrine
Severity: Moderate
Midodrine and Pseudoephedrine: 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 raise blood pressure through adrenergic stimulation, so combined use can cause additive hypertension and changes in heart rate. This is of particular concern in patients with cardiovascular disease or supine hypertension.
What this interaction means in plain words
Midodrine and Pseudoephedrine 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; Pseudoephedrine belongs to Respiratory.
Why it happens
Additive pharmacodynamic vasopressor effect from alpha-1 agonism (midodrine) and indirect sympathomimetic action (pseudoephedrine).
What to do
Avoid routine use of pseudoephedrine decongestants in patients on midodrine where possible; if used, 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 Pseudoephedrine
- Isocarboxazid + Pseudoephedrine Contraindicated
- Phenelzine + Pseudoephedrine Contraindicated
- Pseudoephedrine + Rasagiline Contraindicated
- Pseudoephedrine + Selegiline Contraindicated
- Pseudoephedrine + Selegiline transdermal Contraindicated
- Pseudoephedrine + Tranylcypromine Contraindicated
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 Pseudoephedrine?
MediHelp rates the interaction as moderate. Midodrine and Pseudoephedrine 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 raise blood pressure through adrenergic stimulation, so combined use can cause additive hypertension and changes in heart rate. This is of particular concern in patients with cardiovascular disease or supine hypertension.
How serious is the interaction between Midodrine and Pseudoephedrine?
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 routine use of pseudoephedrine decongestants in patients on midodrine where possible; if used, monitor blood pressure including supine readings and heart rate.
What other medicines interact with Pseudoephedrine?
MediHelp also lists interactions of Pseudoephedrine with, for example, Isocarboxazid, Phenelzine, Rasagiline. The full list is on the Pseudoephedrine page.
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