Drug interactions
Midodrine + Selegiline transdermal
Severity: Major
Midodrine and Selegiline transdermal: major interaction.
Last updated Sources: US FDA label
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 selegiline is an MAO inhibitor, and together they may produce marked hypertension. At the antidepressant transdermal doses, MAO inhibition is non-selective and can potentiate pressor effects.
What this interaction means in plain words
Midodrine and Selegiline transdermal 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.
Why it happens
Additive pressor effects from alpha-1 agonism and MAO inhibition, which raises sympathetic amine levels.
What to do
Avoid if possible; if combined, monitor blood pressure closely including supine readings and use the lowest effective midodrine dose.
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?
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References
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 Selegiline transdermal?
MediHelp rates the interaction as major. Midodrine and Selegiline transdermal 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 selegiline is an MAO inhibitor, and together they may produce marked hypertension. At the antidepressant transdermal doses, MAO inhibition is non-selective and can potentiate pressor effects.
How serious is the interaction between Midodrine and Selegiline transdermal?
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 if possible; if combined, monitor blood pressure closely including supine readings and use the lowest effective midodrine dose.
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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