What medications are used to treat orthostatic hypotension?
Author: SCIRE Community Team | Reviewer: Darryl Caves | Published: 9 April 2018 | Updated: ~
Currently, midodrine hydrochloride (midodrine) is the only medication recommended for managing orthostatic hypotension after SCI. There is not enough evidence to support the use of other medications. However, medications intended to help treat orthostatic hypotension may also have other unwanted effects on blood pressure after SCI, so should be discussed in detail with your health team for more information.
Monitoring blood pressure will help you determine if drug therapy is safe and effective.10
Midodrine hydrochloride (midrodrine, ProAmatine) is a medication that causes the blood vessels to tighten (constrict). When this occurs, more blood flow travels to the heart and blood pressure increases to prevent blood pressure from dropping in standing. Midodrine is taken by mouth in the form of tablets. Regular blood pressure monitoring done by you or your caregiver will be required to ensure the medication is working properly.
There is moderate evidence that midodrine is effective for treating orthostatic hypotension after SCI and may improve exercise performance by decreasing symptoms of low blood pressure.
There are a number of other medications that have been suggested for reducing orthostatic hypotension, but are ineffective or the evidence is inconclusive. These include:
- Fludrocortisone
- Dihydroergotamine or ergotamine
- Ephedrine
- Droxidopa or L-DOPS
- Nitro-L-arginine methyl ester or L-NAME
