Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation NIHR HSRIC. Midodrine (Bramox) for orthostatic hypotension. Birmingham: NIHR Horizon Scanning Research&Intelligence Centre. Horizon Scanning Review. 2015 Authors' objectives Midodrine (Bramox) is intended to be used as a treatment option for patients with severe orthostatic hypotension. It is licensed in the UK for the treatment of orthostatic hypotension due to autonomic dysfunction when corrective factors have been ruled out and other (non-pharmacological) forms of treatment are inadequate. Midodrine is a peripheral α-adrenergic agonist that is almost completely absorbed after oral administration and undergoes enzymatic hydrolysis to form its pharmacologically active metabolite, de-gly-midodrine.
Orthostatic hypotension (or postural hypotension) is a condition in which standing leads to an abnormally large drop in blood pressure that can result in symptoms such as light-headedness, dizziness, blurring of vision, fainting and falls. Orthostatic hypotension is more common in older people, and estimates of prevalence range from 5% to 30% of people aged over 65 years (in the general population), up to 60% of people with Parkinson's disease and up to 70% of people living in nursing homes.
A number of pharmacological and non-pharmacological approaches have been used to treat postural hypotension. Non-pharmacological treatments include increasing water and salt intake, or using compression garments or bandages and physical manoeuvres to counter the drop in blood pressure. Midodrine has recently been licensed in the UK for the treatment of this condition, and a number of drugs have been used off-label to manage orthostatic hypotension. Midodrine has completed a number of trials comparing its effect on standing and supine blood pressure with those of placebo and ephedrine. Indexing Status Subject indexing assigned by CRD MeSH Adrenergic alpha-Agonists; Blood Pressure; Humans; Hypotension, Orthostatic; Midodrine Language Published English Country of organisation England English summary An English language summary is available. Address for correspondence NIHR Horizon Scanning Research&Intelligence Centre, University of Birmingham, Institute of Applied Health Research, Public Health building, Edgbaston, Birmingham B15 2TT
Tel: 0121 414 9077 Email: nihrhsc@contacts.bham.ac.uk AccessionNumber 32016000363 Date abstract record published 04/03/2016 |