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    Old 09-27-2008, 08:49 AM   #1
    ubu2011
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    Midodrine not raising blood pressure

    This morning I checked my blood pressure at 10:00 a.m. and sitting it was 78/47, pulse 89, standing 82/55, pulse 116. I took 5 mg of Midodrine this morning at 10:02 a.m. At 10:18 my sitting blood pressure was 76/50, pulse 90, standing blood pressure 88/52, pulse 113. At 10:45 a.m. my sitting blood pressure was 81/47, pulse 75, standing blood pressure 85/55, pulse 100. At 11:03 a.m. sitting blood pressure 87/51, pulse 79, standing blood pressure 90/61, pulse 95. At 11:30 a.m. sitting blood pressure was 90/49, pulse 81, standing blood pressure 84/53, pulse 98. Why isn't my blood pressure raising that much?

    I am prescribed 5 mg three times a day as needed, but yesterday was the first time I tried Midodrine and since I didn't know how I was going to react to the drug I took 2.5 mg (only had a little bit of tingling in arms and scalp). Then this morning I took the dose what doctor wanted me on, 5 mg, and still didn't do anything to raise blood pressure.

     
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    Old 09-27-2008, 03:20 PM   #2
    aether4
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    Re: Midodrine not raising blood pressure

    You may need a higher dose, discuss this with your doctor before trying it.

    When my blood pressure is really low or my heart rate really high, I'll take an extra 2.5mgs. Usually before work I take 7.5mgs just to get myself going, and because I'm standing so much. But again, make sure your doctor is ok with this.

    It does take about 30 minutes to take affect, and unfortunately in about 3- 3 and a half hours it's wearing off again. One of the things I hate about it.
    It doesn't drastically raise my BP either, but I figure 80s/50s is better than 70s/40s. It does help my heart rate, and I can see it does help your's some, too.
    Does your BP fall ridiculously low when you're laying down relaxed? Like 53/34 range low?

    Our problem is that we don't have normal blood volume, then add that to blood vessels that want to dilate instead of constricting and it's a lot for the midodrine to try to fix.
    There's no miracle cure, nothing is going to completely fix what is wrong with our nervous systems - though for the lucky ones their bodies may eventually heal. If the midodrine really doesn't seem to be helping you at all or enough (give it a month), then discuss other treatment plans with your doctor.

    As far as readings go, I don't see as much of a change. I do feel it as far as symptoms go. I can go shopping without staggering like a drunk, I can stand longer, I can get up without falling over, things like that prove that it does help me. Instead of falling 7-8 times a week I may go 2-3 weeks between near-syncope episodes (and always without midodrine).

    As I've said before, do more research. You'll find more out about what can help, make you feel worse, and generally more about the autonomic nervous system itself. Don't forget to research dysautonomia/autonomic dysfunction.

    Last edited by aether4; 09-27-2008 at 03:21 PM.

     
    Old 09-29-2008, 07:18 AM   #3
    ubu2011
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    Re: Midodrine not raising blood pressure

    is Mododrine a drug that has to build up in your system over time or should it work the first pill you take. The reason I ask is because this is like the third pill I have taken in the the last three days and it isn't doing much at all. I was feeling really bad this morning about an hour after I woke up, frontal head pressure, lightheaded, felt like going to pass out, could feel heart beating, a little short of breath, felt a little nauseous. I hung up clothes for ten minutes, then sat down and took blood pressure and it was 74/45, pulse 94 and standing 84/57, pulse 103. Shouldn't my blood pressure have lowered instead of raise when I stood up? I took 5 mg of midodrine. After an hour I felt a little better and blood pressure sitting went to 86/47, pulse 69, standing blood pressure 88/62, pulse 90.

    My doctor has me on midodrine 5 mg three times a day as needed. Also, I read Vestibular Migraines can cause low blood pressure, fast heart rate, which doctors think may be the cause of my symptoms also. Do you know anything about vestibular migaines?

    Last edited by ubu2011; 09-29-2008 at 08:42 AM.

     
    Old 09-29-2008, 09:05 AM   #4
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    Re: Midodrine not raising blood pressure

    Quote:
    Originally Posted by ubu2011 View Post
    is Mododrine a drug that has to build up in your system over time or should it work the first pill you take.
    No. It has a 3 and a half to 4 hour half-life and does not cross the brain blood barrier. As far as medications go, it's a fairly safe and side-effect free one. However, nothing is perfect and some people do not react well to it. I occasionally do get headaches from it. And yes, most people report the very first dose helping them. My very first dose pepped me up and lead to me cleaning the entire house in 3 hours! It was amazing to have so much energy and actually have a clear head... too bad following doses weren't even remotely near that.

    In a normal person, no, blood pressure should remain around the same or only barely rise when standing. We're not normal but that you're blood pressure does raise shows that your autonomic nervous system control over this does still function. And think of it this way - have you tried standing with your BP in the 70s/40s? It doesn't work very well does it?
    Your pulse is increasing because your heart is trying to fix the problem by moving your blood faster. It doesn't really help us much, instead we just get the tachycardia side effects - short of breath, shaky, and such.

    I don't know much about vestibular migraines, but I know this isn't what I'm having. I do have a history if plain ol' classic migraines, the ones with the horrible auras but luckily those really decreased in frequency around age 21. My last migraine was a flagyl reaction related one. I do know that lack of blood to your brain can cause many neurological symptoms. I honestly think it would do you some good to research this more.

    It does sound as if the midodrine is helping you some. As for why you woke up feeling like death warmed over - How many hours where you asleep and do you still keep up on your high fluid and salt intake? I feel horrible if I don't drink enough water because I dehydrate so easily that I can dehydrate in my sleep. If I happen to sleep in I get a terrible headache.
    Also, most people's BP is lower in the morning. For us that makes for extra low BP. I've seen someone speculate that maybe some of us have cortisol problems - cortisol is what gives your body a boost in the morning and helps it get going, as well as raising up blood pressure.


    A pulse of 90s- low 100s doesn't sound too bad - hopefully the midodrine will help keep you down around there. It helps me usually, but sometimes my heart rate is too much for it - just the other day it did 173bpm while on the midodrine. lol

     
    Old 09-29-2008, 09:36 AM   #5
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    Re: Midodrine not raising blood pressure

    Like I said, I took the Midodrine at 9:30 this morning. I just went to get the mail (it is now 12:10 p.m.) l got to the bottom of the stairs, felt shaky, felt like I was going to fall, a little dizzy. I felt the same way yesterday after I took it but yesterday took my Antivert 1 hour before I took the Midodrine. I felt like fainting while I was grocery shopping. I don't think the midodrine is working for me. I liked the fludrocortisone better, although it stopped working for me.

     
    Old 09-29-2008, 12:58 PM   #6
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    Re: Midodrine not raising blood pressure

    It seems Antivert has some anticholinergic properties. While this can be used for those that have NCS just from increased vagal tone, it's contradicted for those of us who have vasodilation problems (which is why we've been prescribed midodrine).

    Last month I was in the ER due to a bad bacteria infection, dehydration, and cause my heart rate would not go down. Because I had nausea I was prescribed Promethazine. The attending doctor did not listen when I said I was on midodrine - I even spelled it out for him but for some reason he assumed I meant Midrine. It turns out that the two interact terribly. NASA actually did a study over it because they give their astronauts midodrine and if they have bad nausea, Promethazine. Every single subject that took the two together had them interact. Prometazine also has strong anticholinergic properties and isn't supposed to be used in those with very bad hypotension. So you may want to make sure your Antivert (Meclizine) isn't interacting or making you worse.


    If you do end up staying on midodrine get used to no one knowing what the medication is or what possible interactions there are... So you have to be the one to know, prevent, or at least recognize them. It's the same with your what you have. I'm actually hoping the anesthesiologist will call me today because I doubt she's dealt with putting someone with NCS under before (anesthetics can make blood pressure fall more) so I have to make sure she understands.

    Keep researching, you can find better resources elsewhere and there's a lot of stuff that can't be put on here...

    Last edited by aether4; 09-29-2008 at 01:02 PM.

     
    Old 09-29-2008, 01:02 PM   #7
    ubu2011
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    Re: Midodrine not raising blood pressure

    I only take Antivert on as needed basis. I didn't have any Antivert this morning and still felt the same way as I did yesterday.

    Before I started Midodrine I asked the pharmacist if it was okay to take Antivert and Midodrine together and he said it wouldn't be a problem.

    I read the pamphlet you get when you get your medication from the pharmacist and it says nothing about dizziness. I don't know. Guess I will have to discuss it with my doctor.

    Thank you so much for the information, very helpful.

    Last edited by ubu2011; 09-29-2008 at 01:05 PM.

     
    Old 09-29-2008, 01:04 PM   #8
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    Re: Midodrine not raising blood pressure

    And my pharmacist filled the Promethazine without batting an eye...

    Really all you can do is find a dysautonomia specialist if the more common treatments aren't working. They'd be more likely to be familiar with newer meds and off label use/doses.

     
    Old 09-29-2008, 01:06 PM   #9
    ubu2011
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    Re: Midodrine not raising blood pressure

    I didn't know there was such a thing, dysautonomia specialist.

    Thank you. I will look for one in my area.

     
    Old 09-29-2008, 01:08 PM   #10
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    Re: Midodrine not raising blood pressure

    Research - there are groups that have lists of doctors and clinics that specialize in this. The Mayo Cleveland Clinic is one - and a lot closer to you than me.

    Put this in any search engine "dysautonomia information" and "dysautonomia research".

    Last edited by aether4; 09-29-2008 at 01:11 PM.

     
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