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Drug interactions

Midodrine + Rasagiline

Severity: Major

Midodrine and Rasagiline: major interaction.

Last updated Sources: UK SmPC

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, and MAO inhibitors may potentiate pressor effects, risking marked hypertension. Labeling advises against concurrent use with MAO inhibitors.

What this interaction means in plain words

Midodrine and Rasagiline can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.

Midodrine belongs to Miscellaneous; Rasagiline belongs to Central Nervous System.

Evidence level: Moderate

Why it happens

Additive vasopressor effect: midodrine's alpha-1 agonism combined with MAO inhibition enhances sympathetic activity.

What to do

Avoid the combination where possible. If unavoidable, monitor supine and standing blood pressure closely and reduce the midodrine dose as needed.

What to ask your pharmacist

  • Does the benefit of taking both outweigh the risk in my case?
  • Do I need any blood test, ECG or other check while on both?
  • What early warning signs should I watch for, and what should I do if they appear?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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References

Frequently asked questions

Can I take Midodrine with Rasagiline?

MediHelp rates the interaction as major. Midodrine and Rasagiline can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Midodrine is an alpha-1 agonist, and MAO inhibitors may potentiate pressor effects, risking marked hypertension. Labeling advises against concurrent use with MAO inhibitors.

How serious is the interaction between Midodrine and Rasagiline?

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible. If unavoidable, monitor supine and standing blood pressure closely and reduce the midodrine dose as needed.

What other medicines interact with Rasagiline?

MediHelp also lists interactions of Rasagiline with, for example, Atomoxetine, Brimonidine, Bupropion-naltrexone. The full list is on the Rasagiline page.

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