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Concomitant treatment with sympathomimetics and other vasoconstrictive substances such as reserpine, guanethidine, tricyclic antidepressants, antihistamines, thyroid hormones and MAO-inhibitors should be avoided as a pronounced increase in blood pressure may occur.
As with other specific α-adrenergic agonists, the effect of midodrine is blocked by α-adrenergic blockers such as prazosine and doxazosine and vice versa.
Simultaneous use of digitalis preparations is not recommended, since the bradycardia which occurs as a result of the use of midodrine is then potentiated and heart block may occur.
Midodrine may potentiate the hypertensive effects of fludrocortisone acetate.
Monitoring is recommended if midodrine is combined with other drugs that directly or indirectly reduce the heart rate.
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