Details of the Drug

General Information of Drug (ID: DME2PY5)

Drug Name

Midodrine

Synonyms

Alphamine; Amatine; Gutron; Hipertan; Metligene; Midamine; Midodrin; Midodrina; Midodrinum; ProAmatine; MIDODRINE HYDROCHLORIDE; Midodrine HCL; Midodrine Monohydrochloride; Midodrine hydrochloride [USAN]; A 4020 Linz; St 1085; TS 701; A-4020 Linz; Midodrina [INN-Spanish]; Midodrine (INN); Midodrine [BAN:INN]; Midodrine [INN:BAN]; Midodrine hydrochloride [USAN:JAN]; Midodrinum [INN-Latin]; Pro-Amatine; Proamatine (TN); ST-1085; St. Peter 224; Midodrine hydrochloride (JAN/USAN); Pro-Amatine (TN); DL-N1-(beta-Hydroxy-2,5-dimethoxyphenethyl)glycinamid; N-[2-(2,5-dimethoxyphenyl)-2-hydroxyethyl]glycinamide; N-{2-[2,5-bis(methyloxy)phenyl]-2-hydroxyethyl}glycinamide; [+/-]-1-[2,5-Dimethoxyphenyl]-2-glycinamidoethanol; Acetamide, 2-amino-N-(beta-hydroxy-2,5-dimethoxyphenethyl)-, hydrochloride; Acetamide, 2-amino-N-(2-(2,5-dimethoxyphenyl)-2-hydroxyethyl)-, monohydrochloride; (+-)-1-(2',5'-Dimethoxyphenyl)-2-glycinamidoethanol hydrochloride; (+-)-2-Amino-N-(beta-hydroxy-2,5-dimethoxyphenethyl)acetamide monohydrochloride; (+-)-Midodrine hydrochloride; (+/-)-1-(2,5-Dimethoxyphenyl)-2-glycinamidoethanol; (-)-Midodrin hydrochloride; (-)-Midodrine hydrochloride; (RS)-N'-(beta-Hydroxy-2,5-dimethoxy-phenethyl)glycinamid; 1-(2',5'-Dimethoxyphenyl)-2-glycinamidoethanol; 1-(2',5'-Dimethoxyphenyl)-2-glycinamidoethanol hydrochloride; 1-(2,5-Dimethoxyphenyl)-2-glycinamidoethanol; 2-Amino-N-(2,5-dimethoxy-beta-hydroxyphenethyl)acetamid; 2-Amino-N-(2,5-dimethoxy-beta-hydroxyphenethyl)acetamide; 2-Amino-N-(2,5-dimethoxy-beta-hydroxyphenethylacetamide; 2-Amino-N-(2-(2,5-dimethoxyphenyl)-2-hydroxyethyl)acetamide monohydrochloride; 2-Amino-N-(2-(2,5-dimethoxyphenyl)-2-hyyroxyethyl)acetamide monohydrochloride; 2-amino-N-[2-(2,5-dimethoxyphenyl)-2-hydroxyethyl]acetamide; 2-amino-N-[2-(2,5-dimethoxyphenyl)-2-hydroxyethyl]acetamide hydrochloride

Indication

Disease Entry	ICD 11	Status	REF
Orthostatic hypotension	BA21	Approved	[1]
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Therapeutic Class

Vasoconstrictor Agents

Drug Type

Small molecular drug

Structure

3D MOL

2D MOL

#Ro5 Violations (Lipinski): 0

Molecular Weight (mw)

254.28

Logarithm of the Partition Coefficient (xlogp)

-0.6

Rotatable Bond Count (rotbonds)

Hydrogen Bond Donor Count (hbonddonor)

Hydrogen Bond Acceptor Count (hbondacc)

ADMET Property

Bioavailability: 93% of drug becomes completely available to its intended biological destination(s) [2]
Clearance: The renal clearance of drug is 385 mL/min []
Half-life: The concentration or amount of drug in body reduced by one-half in 3 - 4 hours [3]
Metabolism: The drug is metabolized via the liver []
MRTD: The Maximum Recommended Therapeutic Dose (MRTD) of drug that ensured maximising efficacy and moderate side effect is 0.98314 micromolar/kg/day [4]
Unbound Fraction: The unbound fraction of drug in plasma is 0.7% [3]
Vd: Fluid volume that would be required to contain the amount of drug present in the body at the same concentration as in the plasma 0.67 L/kg [3]

Chemical Identifiers

Formula: C12H18N2O4
IUPAC Name: 2-amino-N-[2-(2,5-dimethoxyphenyl)-2-hydroxyethyl]acetamide
Canonical SMILES: COC1=CC(=C(C=C1)OC)C(CNC(=O)CN)O
InChI: InChI=1S/C12H18N2O4/c1-17-8-3-4-11(18-2)9(5-8)10(15)7-14-12(16)6-13/h3-5,10,15H,6-7,13H2,1-2H3,(H,14,16)
InChIKey: PTKSEFOSCHHMPD-UHFFFAOYSA-N

Cross-matching ID

PubChem CID: 4195
ChEBI ID: CHEBI:6933
CAS Number: 42794-76-3
DrugBank ID: DB00211
TTD ID: D02XJY
VARIDT ID: DR01164
INTEDE ID: DR1088
ACDINA ID: D00430

Combinatorial Drugs (CBD)

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Molecular Interaction Atlas of This Drug

Drug Therapeutic Target (DTT)

DTT Name	DTT ID	UniProt ID	MOA	REF
Adrenergic receptor Alpha-1 (ADRA1)	TTG28O6	NOUNIPROTAC	Agonist	[5]

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Drug Transporter (DTP)

DTP Name	DTP ID	UniProt ID	MOA	REF
Peptide transporter 1 (SLC15A1)	DT9G7XN	S15A1_HUMAN	Substrate	[6]

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Drug-Metabolizing Enzyme (DME)

DME Name	DME ID	UniProt ID	MOA	REF
Cytochrome P450 2D6 (CYP2D6)_{Main DME}	DECB0K3	CP2D6_HUMAN	Substrate	[7]

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Molecular Interaction Atlas (MIA)

MIA Detail

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Drug-Drug Interaction (DDI) Information of This Drug

Coadministration of a Drug Treating the Disease Different from Midodrine (Comorbidity)

DDI Drug Name	DDI Drug ID	Severity	Mechanism	Comorbidity	REF
Methylergonovine	DMBEX4O	Major	Additive hypertensive effects by the combination of Midodrine and Methylergonovine.	Abortion [JA00]	[8]
Methylene blue	DMJAPE7	Moderate	Additive hypertensive effects by the combination of Midodrine and Methylene blue.	Acquired methaemoglobinaemia [3A93]	[9]
Ranolazine	DM0C9IL	Moderate	Decreased metabolism of Midodrine caused by Ranolazine mediated inhibition of CYP450 enzyme.	Angina pectoris [BA40]	[10]
Dronedarone	DMA8FS5	Moderate	Decreased metabolism of Midodrine caused by Dronedarone mediated inhibition of CYP450 enzyme.	Angina pectoris [BA40]	[11]
Clobazam - Lundbeck	DMW1OQ0	Moderate	Decreased metabolism of Midodrine caused by Clobazam - Lundbeck mediated inhibition of CYP450 enzyme.	Anxiety disorder [6B00-6B0Z]	[12]
Droxidopa	DM5YF4M	Moderate	Additive hypertensive effects by the combination of Midodrine and Droxidopa.	Autonomic nervous system disorder [8D87]	[13]
Linezolid	DMGFPU2	Major	Additive hypertensive effects by the combination of Midodrine and Linezolid.	Bacterial infection [1A00-1C4Z]	[14]
Levomilnacipran	DMV26S8	Moderate	Increased risk of rapid heart rate by the combination of Midodrine and Levomilnacipran.	Chronic pain [MG30]	[15]
Selegiline	DM6034S	Moderate	Additive hypertensive effects by the combination of Midodrine and Selegiline.	Depression [6A70-6A7Z]	[9]
Duloxetine	DM9BI7M	Moderate	Increased risk of rapid heart rate by the combination of Midodrine and Duloxetine.	Depression [6A70-6A7Z]	[15]
Isocarboxazid	DMAF1NB	Moderate	Additive hypertensive effects by the combination of Midodrine and Isocarboxazid.	Depression [6A70-6A7Z]	[9]
Milnacipran	DMBFE74	Moderate	Increased risk of rapid heart rate by the combination of Midodrine and Milnacipran.	Depression [6A70-6A7Z]	[15]
Tranylcypromine	DMGB5RE	Moderate	Additive hypertensive effects by the combination of Midodrine and Tranylcypromine.	Depression [6A70-6A7Z]	[9]
Desvenlafaxine	DMHD4PE	Moderate	Additive hypertensive effects by the combination of Midodrine and Desvenlafaxine.	Depression [6A70-6A7Z]	[15]
Phenelzine	DMHIDUE	Moderate	Additive hypertensive effects by the combination of Midodrine and Phenelzine.	Depression [6A70-6A7Z]	[9]
Venlafaxine	DMR6QH0	Moderate	Increased risk of rapid heart rate by the combination of Midodrine and Venlafaxine.	Depression [6A70-6A7Z]	[15]
Mirabegron	DMS1GYT	Moderate	Decreased metabolism of Midodrine caused by Mirabegron mediated inhibition of CYP450 enzyme.	Functional bladder disorder [GC50]	[16]
Darifenacin	DMWXLYZ	Moderate	Decreased metabolism of Midodrine caused by Darifenacin mediated inhibition of CYP450 enzyme.	Functional bladder disorder [GC50]	[17]
Ergotamine	DMKR3C5	Major	Additive hypertensive effects by the combination of Midodrine and Ergotamine.	Headache [8A80-8A84]	[8]
Cobicistat	DM6L4H2	Moderate	Decreased metabolism of Midodrine caused by Cobicistat mediated inhibition of CYP450 enzyme.	Human immunodeficiency virus disease [1C60-1C62]	[18]
Givosiran	DM5PFIJ	Moderate	Decreased metabolism of Midodrine caused by Givosiran mediated inhibition of CYP450 enzyme.	Inborn porphyrin/heme metabolism error [5C58]	[19]
Berotralstat	DMWA2DZ	Moderate	Decreased metabolism of Midodrine caused by Berotralstat mediated inhibition of CYP450 enzyme.	Innate/adaptive immunodeficiency [4A00]	[20]
Glycerol phenylbutyrate	DMDGRQO	Moderate	Decreased metabolism of Midodrine caused by Glycerol phenylbutyrate mediated inhibition of CYP450 enzyme.	Liver disease [DB90-DB9Z]	[21]
Dacomitinib	DMOH8VY	Moderate	Decreased metabolism of Midodrine caused by Dacomitinib mediated inhibition of CYP450 enzyme.	Lung cancer [2C25]	[22]
Vemurafenib	DM62UG5	Moderate	Decreased metabolism of Midodrine caused by Vemurafenib mediated inhibition of CYP450 enzyme.	Melanoma [2C30]	[23]
Methysergide	DM1EF73	Major	Additive hypertensive effects by the combination of Midodrine and Methysergide.	Migraine [8A80]	[8]
Dihydroergotamine	DM5IKUF	Major	Additive hypertensive effects by the combination of Midodrine and Dihydroergotamine.	Migraine [8A80]	[8]
Panobinostat	DM58WKG	Moderate	Decreased metabolism of Midodrine caused by Panobinostat mediated inhibition of CYP450 enzyme.	Multiple myeloma [2A83]	[24]
Ozanimod	DMT6AM2	Moderate	Additive hypertensive effects by the combination of Midodrine and Ozanimod.	Multiple sclerosis [8A40]	[9]
Fedratinib	DM4ZBK6	Moderate	Decreased metabolism of Midodrine caused by Fedratinib mediated inhibition of CYP450 enzyme.	Myeloproliferative neoplasm [2A20]	[21]
Nilotinib	DM7HXWT	Moderate	Decreased metabolism of Midodrine caused by Nilotinib mediated inhibition of CYP450 enzyme.	Myeloproliferative neoplasm [2A20]	[25]
Promethazine	DM6I5GR	Moderate	Increased plasma concentrations of Midodrine and Promethazine due to competitive inhibition of the same metabolic pathway.	Nausea/vomiting [MD90]	[26]
Rolapitant	DM8XP26	Moderate	Decreased metabolism of Midodrine caused by Rolapitant mediated inhibition of CYP450 enzyme.	Nausea/vomiting [MD90]	[27]
Sibutramine	DMFJTDI	Moderate	Increased risk of rapid heart rate by the combination of Midodrine and Sibutramine.	Obesity [5B80-5B81]	[28]
Lorcaserin	DMG6OYJ	Moderate	Decreased metabolism of Midodrine caused by Lorcaserin mediated inhibition of CYP450 enzyme.	Obesity [5B80-5B81]	[29]
Rasagiline	DM3WKQ4	Moderate	Additive hypertensive effects by the combination of Midodrine and Rasagiline.	Parkinsonism [8A00]	[9]
Ergonovine	DM0VEC1	Major	Additive hypertensive effects by the combination of Midodrine and Ergonovine.	Postpartum haemorrhage [JA43]	[8]
ABIRATERONE	DM8V75C	Moderate	Decreased metabolism of Midodrine caused by ABIRATERONE mediated inhibition of CYP450 enzyme.	Prostate cancer [2C82]	[30]
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Drug Inactive Ingredient(s) (DIG) and Formulation(s) of This Drug

DIG

DIG Name	DIG ID	PubChem CID	Functional Classification
Allura red AC dye	E00338	33258	Colorant
FD&C blue no. 1	E00263	19700	Colorant
FD&C blue no. 2	E00446	2723854	Colorant
Quinoline yellow WS	E00309	24671	Colorant
Sodium lauryl sulfate	E00464	3423265	Emulsifying agent; Modified-release agent; Penetration agent; Solubilizing agent; Surfactant; lubricant
Sunset yellow FCF	E00255	17730	Colorant
Carmellose sodium	E00625	Not Available	Disintegrant
Magnesium stearate	E00208	11177	lubricant
Silicon dioxide	E00670	Not Available	Anticaking agent; Opacifying agent; Viscosity-controlling agent
Talc	E00520	16211421	Anticaking agent; Diluent; Glidant; lubricant
Hydrophobic colloidal silica	E00285	24261	Anticaking agent; Emulsion stabilizing agent; Glidant; Suspending agent; Viscosity-controlling agent
Cellulose microcrystalline	E00698	Not Available	Adsorbent; Suspending agent; Diluent
Pregelatinized starch	E00674	Not Available	Binding agent; Diluent; Disintegrant
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⏷ Show the Full List of 13 Pharmaceutical Excipients of This Drug

Pharmaceutical Formulation

Formulation Name	Drug Dosage	Dosage Form	Route
Midodrine 10 mg tablet	10 mg	Oral Tablet	Oral
Midodrine 2.5 mg tablet	2.5 mg	Oral Tablet	Oral
Midodrine 5 mg tablet	5 mg	Oral Tablet	Oral
Midodrine Hydrochloride 10mg tablet	10mg	Tablet	Oral
Midodrine Hydrochloride 5mg tablet	5mg	Tablet	Oral

Jump to Detail Pharmaceutical Formulation Page of This Drug

References

1	URL: http://www.guidetopharmacology.org Nucleic Acids Res. 2015 Oct 12. pii: gkv1037. The IUPHAR/BPS Guide to PHARMACOLOGY in 2016: towards curated quantitative interactions between 1300 protein targets and 6000 ligands. (Ligand id: 7240).
2	Critical Evaluation of Human Oral Bioavailability for Pharmaceutical Drugs by Using Various Cheminformatics Approaches
3	Trend Analysis of a Database of Intravenous Pharmacokinetic Parameters in Humans for 1352 Drug Compounds
4	Estimating the safe starting dose in phase I clinical trials and no observed effect level based on QSAR modeling of the human maximum recommended daily dose
5	Orthostatic hypotension in patients with Parkinson's disease: pathophysiology and management. Drugs Aging. 2001;18(7):495-505.
6	Transport characteristics of a novel peptide transporter 1 substrate, antihypotensive drug midodrine, and its amino acid derivatives. J Pharmacol Exp Ther. 2006 Jul;318(1):455-60.
7	Akathisia with combined use of midodrine and promethazine. JAMA. 2006 May 3;295(17):2000-1. Letter
8	Barthel W, Glusa E, Koth W "Interactions of dihydroergotamine with etilefrine in human leg veins in vitro and in situ." Int J Clin Pharmacol Ther Toxicol 25 (1987): 63-9. [PMID: 2881898]
9	Ban TA "Drug interactions with psychoactive drugs." Dis Nerv Syst 36 (1975): 164-6. [PMID: 1116424]
10	Product Information. Ranexa (ranolazine). Calmoseptine Inc, Huntington Beach, CA.
11	Product Information. Multaq (dronedarone). sanofi-aventis , Bridgewater, NJ.
12	Product Information. Onfi (clobazam). Lundbeck Inc, Deerfield, IL.
13	Product Information. Northera (droxidopa). Chelsea Therapeutics Inc, Charlotte, NC.
14	Hendershot PE, Antal EJ, Welshman IR, Batts DH, Hopkins NK "Linezolid: pharmacokinetic and pharmacodynamic evaluation of coadministration with pseudoephedrine HCl, phenylpropanolamine HCl, and dextromethorpan HBr." J Clin Pharmacol 41 (2001): 563-72. [PMID: 11361053]
15	Product Information. Cymbalta (duloxetine). Lilly, Eli and Company, Indianapolis, IN.
16	Product Information. Myrbetriq (mirabegron). Astellas Pharma US, Inc, Deerfield, IL.
17	Product Information. Enablex (darifenacin). Novartis Pharmaceuticals, East Hanover, NJ.
18	Product Information. Stribild (cobicistat/elvitegravir/emtricitabine/tenofov). Gilead Sciences, Foster City, CA.
19	Product Information. Givlaari (givosiran). Alnylam Pharmaceuticals, Cambridge, MA.
20	Product Information. Orladeyo (berotralstat). BioCryst Pharmaceuticals Inc, Durham, NC.
21	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
22	Product Information. Vizimpro (dacomitinib). Pfizer U.S. Pharmaceuticals Group, New York, NY.
23	Product Information. Zelboraf (vemurafenib). Genentech, South San Francisco, CA.
24	Product Information. Farydak (panobinostat). Novartis Pharmaceuticals, East Hanover, NJ.
25	Product Information. Tasigna (nilotinib). Novartis Pharmaceuticals, East Hanover, NJ.
26	Platts SH, Shi SJ, Meck JV "Akathisia with combined use of midodrine and promethazine." JAMA 295 (2006): 2000-1. [PMID: 16670408]
27	Product Information. Varubi (rolapitant). Tesaro Inc., Waltham, MA.
28	Product Information. Meridia (sibutramine). Knoll Pharmaceutical Company, Whippany, NJ.
29	Product Information. Belviq (lorcaserin). Eisai Inc, Teaneck, NJ.
30	Product Information. Zytiga (abiraterone). Centocor Inc, Malvern, PA.