Details of Drug-Drug Interaction
| Drug General Information (ID: DDIXFP8TBY) | |||||||||
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| Drug Name | Midodrine | Drug Info | Epinephrine (topical) | Drug Info | |||||
| Drug Type | Small molecule | Small molecule | |||||||
| Therapeutic Class | Vasoconstrictor Agents | Vasoconstrictor Agents | |||||||
| Structure | |||||||||
| Mechanism of Midodrine-Epinephrine (topical) Interaction (Severity Level: Moderate) | |||||||||
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| Additive hypertensive effects Click to Show/Hide Mechanism Graph | |||||||||
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| Drug Name | Midodrine | Epinephrine (topical) | |||||||
| Mechanism |
Hypertensive effects Alpha-1 adrenergic receptor Agonist |
Hypertensive effects Alpha-1 adrenergic receptor Agonist |
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| Key Mechanism Factor 1 | |||||||||
| Factor Name | Adrenergic receptor alpha-1 | Structure Sequence | |||||||
| Protein Family | G-protein coupled receptor 1 family | ||||||||
| Protein Function |
This alpha-adrenergic receptor mediates its action by association with G proteins that activate a phosphatidylinositol-calcium second messenger system. Its effect is mediated by G(q) and G(11) proteins. Nuclear ADRA1A-ADRA1B heterooligomers regulate phenylephrine(PE)-stimulated ERK signaling in cardiac myocytes.
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| Mechanism Description |
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| Recommended Action | |||||||||
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| Management | Caution is advised if midodrine must be used in combination with other agents that can increase blood pressure. Supine and sitting blood pressures should be closely monitored. Supine hypertension can often be controlled by keeping the patient from being fully supine, for example, sleeping with the head of the bed elevated. Taking the last daily dose of midodrine 3 to 4 hours before bedtime may also help to minimize nighttime supine hypertension. Patients should be advised to contact their physician immediately if they experience symptoms of supine hypertension such as cardiac awareness, pounding in the ears, headache, and blurred vision. Midodrine should be discontinued if supine hypertension persists. | ||||||||
| References | |||||||||||||||||||
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| 1 | Cerner Multum, Inc. "UK Summary of Product Characteristics.". | ||||||||||||||||||
| 2 | Product Information. ProAmatine (midodrine). Roberts Pharmaceutical Corporation, Eatontown, NJ. | ||||||||||||||||||