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Proamatine (midodrine)

Indications

Proamatine is used to treat orthostatic hypotension (a condition where blood pressure drops upon standing), which can cause dizziness, lightheadedness, and fainting. It helps increase blood pressure to prevent these symptoms.

Dosage and Administration

• Take Proamatine exactly as prescribed by your healthcare provider.
• Take the tablet with a full glass of water.
• Take Proamatine during the daytime, preferably when you are upright and active, as taking it at bedtime can cause high blood pressure when lying down.
• Follow a regular schedule to maintain an even level of medication in your body.
• Do not take Proamatine within 4 hours of bedtime to avoid lying down with elevated blood pressure.
• Avoid activities that require prolonged sitting or lying down after taking Proamatine.
• Do not stop taking Proamatine suddenly without consulting your doctor, as this can cause a sudden drop in blood pressure.
• Do not take it if you have severe heart disease, urinary retention, or pheochromocytoma.

Mechanism of Action

Proamatine is an alpha-adrenergic agonist. It works by constricting (narrowing) the blood vessels and increasing peripheral resistance, which helps to raise blood pressure in patients with orthostatic hypotension.

Contraindications

• Do not use Proamatine if you have severe heart disease or an overactive thyroid.
• Avoid use if you have urinary retention or difficulty urinating.
• Do not take Proamatine if you have pheochromocytoma, a tumor of the adrenal gland.
• Not recommended for individuals with high blood pressure while lying down (supine hypertension).

Side Effects

Common Side Effects

• Goosebumps (piloerection)
• Chills
• Increased urination
• Itching or tingling scalp
• Dry mouth

Serious Side Effects

• Severe hypertension (high blood pressure) when lying down
• Bradycardia (slow heart rate)
• Irregular heartbeats
• Chest pain
• Fainting or feeling faint

Precautions

• Inform your doctor if you have a history of heart disease, kidney disease, or liver disease before starting Proamatine.
• Regularly monitor your blood pressure both sitting and lying down to check for supine hypertension.
• Avoid taking Proamatine late in the day to prevent high blood pressure while lying down.
• Report any signs of high blood pressure (e.g., severe headache, blurred vision, chest pain) to your healthcare provider immediately.
• Discuss with your doctor if you are pregnant, planning to become pregnant, or breastfeeding before using Proamatine.

Storage Instructions

• Store Proamatine tablets at room temperature, between 20°C to 25°C (68°F to 77°F).
• Keep the tablets in their original container, tightly closed, to protect them from moisture.
• Do not store it in the bathroom or near a sink.
• Keep out of reach of children and pets.

References

https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/019815s010lbl.pdf