Drug interactions
Midodrine + Sevoflurane
Severity: Moderate
Midodrine and Sevoflurane: 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 is an alpha-1 agonist that raises blood pressure and may cause reflex bradycardia. During sevoflurane anesthesia, vasodilation and hemodynamic instability make blood pressure responses unpredictable, and supine hypertension can be pronounced.
What this interaction means in plain words
Midodrine and Sevoflurane 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; Sevoflurane belongs to Central Nervous System.
Why it happens
Opposing pharmacodynamic vascular effects, with an alpha-1 agonist pressor action against anesthetic-induced vasodilation.
What to do
Consider withholding midodrine on the morning of surgery according to local practice. Monitor blood pressure and heart rate continuously and treat hypertension or bradycardia as needed.
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 Sevoflurane
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 Sevoflurane?
MediHelp rates the interaction as moderate. Midodrine and Sevoflurane 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 is an alpha-1 agonist that raises blood pressure and may cause reflex bradycardia. During sevoflurane anesthesia, vasodilation and hemodynamic instability make blood pressure responses unpredictable, and supine hypertension can be pronounced.
How serious is the interaction between Midodrine and Sevoflurane?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Consider withholding midodrine on the morning of surgery according to local practice. Monitor blood pressure and heart rate continuously and treat hypertension or bradycardia as needed.
What other medicines interact with Sevoflurane?
MediHelp also lists interactions of Sevoflurane with, for example, Amiodarone, Amisulpride, Arsenic trioxide. The full list is on the Sevoflurane page.
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