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First dose of Midodrine ended in visit to ER

Hopefully someone can shed some light on what happened today! I started Midodrine today 2.5mg 3x a day. I also take 25mg of atenolol 2x a day. Within 10-15 minutes of taking it my heart rate shot up to 150 and my blood pressure was 150/91 and started experiencing a lot of PVCs some 4 or 5 in a row. No one was home with me and I got worried..

So to be on the safe side I called 911. They took me to the hospital and on the way there my heart rate slowed down and went back up a few times. We waited for 6 hours because quite a few trauma patients came in while we were there.. So I was on a stretcher in the hall with paramedics attending to me,

I got the expected  creepy crawly feeling on my scalp and goose bumps.. I got a horrible headache..By 2 hours after being there it was time to take my atenolol and within 4 hours after the midodrine everything was back to normal.

My blood pressure was staying under 100/60 so they were giving me iv fluids and oxygen to try and keep my blood pressure up.

The doctor finally saw me and said I am one of very few people he has seen taking this drug (midodrine) and that they do not get too many patients with POTS in the ER. So he had no answers for me but suggested I not take the Midodrine again until I see my cardiologist again.

Does anyone have any ideas why my heart rate went so high taking midodrine? I do not see this as being a side effect of the medication...
11 Responses
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875426 tn?1325528416
I didn't know that about house centipedes.  They sure are creepy looking.
Helpful - 0
612876 tn?1355514495
I'm glad we can make each other laugh now and then.  I think we had been trying to make a point of bookmarking our more entertaining threads at one point, but I will openly admit I—for one—am woefully behind on updating health pages, including bookmarking important threads/posts.  

You've got to watch out for those lecherous spiders!  Don't even get me started on the house centipedes ... Ack!!  I suppose they do have one redeeming quality:  they go after the spiders.  :-p
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Avatar universal
Thank you for your reassuring words (everyone). I appreciate you take time out of your day especially when you are probably dealing with your own symptoms!

Heiferly, I was reading a post earlier you had commented on that made me laugh. You had a spider crawl on your computer and you sat in a corner waiting until your nurse came to kill it. I have the same intense fear of anything with more than 4 legs and can definitely relate to that!  
Helpful - 0
612876 tn?1355514495
A side effect of beta blockers can be lower bp, so that may be what stopped your BP from going up after you took the atenolol.  

I don't have an explanation for the rest of it with regard to the midodrine, though.  I definitely hope your cardiologist gets to the bottom of it with you.  Hopefully they can make an adjustment that solves the issue or suggest an alternate medication.  There are plenty of other treatments out there, so don't worry if you can't tolerate the midodrine for whatever reason!

I'm glad that you had no serious lasting effects from the reaction, and I hope you find out something positive when you see your cardio in January.  Do keep us updated.  I do understand how unsettling PVCs can be.  Like you, even understanding that they are benign, I am cautious whenever any arrhythmia I have takes on a pattern or symptomology that is atypical *for me* and will generally either put in a call to my cardiologist's nurse or (if it seems particularly urgent/distressing) to the cardiologist on call to inquire about whether or not I should be concerned about the change.  In one or two instances they have told me to head to the hospital, so it really is best to refer to the discretion of the experts whenever something is different than what is normal in our own individual case.
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Avatar universal
Heiferly, I am not on any medications or supplements. My blood pressure was up and down until I took the atenolol. Then it stopped going up because the midodrine was wearing off I suppose.

I could probably tolerate all the body sensations I got even the headache while taking the midodrine but I did not feel comfortable with my heart racing and PVCs. I am quite used to the occasional PVC but not when they are happening 4+ in a row. That scares me. I have been told they are benign but still its a little unsettling for me :(...I have sceduled another appointment with my cardiologist on Jan 23rd. I won't try taking the drug again until I see the dr.
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875426 tn?1325528416
In every day English, it sounds like it is supposed to raise blood pressure without getting the heart involved.
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875426 tn?1325528416
Your body's mechanism to raise blood pressure with P.O.T.S. involves your heart rate speeding up.  However, this is a vasoconstricting drug that forms a metabolite in active form which is suppose to not be stimulating to cardiac beta-adrenergic receptors according to official FDA information.
Helpful - 0
1399250 tn?1436943297
Yeah... midodrine has made my life even worse, I remember one of the worse side effects I had was tingling but it wasn't just around the scalp sometimes it would be my whole body. I Started to develop horrible head pressure after I started the drug and now the pressure is a bigger problem than my POTS. I'd assume midodrine increase heart rate though? Because I thought in order to raise blood pressure you need to raise heart rate.
Helpful - 0
875426 tn?1325528416
What I seem to recall was that midodrine gave me chest pains... don't know if it increased my heart rate or not, but I did go off that drug.  I'm sorry you had an adverse reaction!
Helpful - 0
Avatar universal
I  WAS UNABLE TO TAKE MIDODRINE AS WELL, HAD ALL KINDS OF PROBLEMS AND IT REALLY DID NOT HELP WITH MY PAF. SO YOU ARE NOT ALONE.
Helpful - 0
612876 tn?1355514495
I've got nothing.  They did start you on a very low dose of the Midodrine, so I definitely don't think it's likely to be dose-related.  Are you taking any other medications or supplements that it possibly could have interacted with?

Did your systolic BP remain elevated until you took the atenolol, or did it go down before that?  I'm not sure what to make of the fact that your pulse pressure widened to 60 during this episode; one would expect a wide pulse pressure like that during exertion (i.e. exercise).  I'm not sure what other things can cause that to occur.  

I definitely think a phone call to your cardiologist would be warranted, rather than waiting it out until your next appointment to let him/her know that the medicine didn't work out as expected.  They may have further advice.
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