MIDODRINE

What is midodrine (ProAmatine, Orvaten)?

Midodrine is an alpha-adrenergic agonist used to increase blood pressure. Midodrine works by constricting the blood vessels, increasing the flow of blood, which in turn increases blood pressure.

How can midodrine work in long-COVID?

Patients diagnosed with long-COVID can experience lightheadedness, postural orthostatic tachycardia syndrome (POTS), chest pain, and a fast heartbeat. To manage symptoms, several clinicians have turned to midodrine as a treatment option. Patients diagnosed with POTS have issues with blood pressure, especially when going from sitting/lying down to standing. The baroreceptors (pressure receptors) do not respond to the change in gravity, causing dysregulated blood pressure. This can cause episodes of fainting, lightheadedness, or falling [1].

Since midodrine constricts blood vessels, it helps restore the balance of blood flow, reducing fainting or lightheadedness. Midodrine use for POTS is relatively well-known and is listed as part of the guideline management of long-COVID patients at Oregon Health and Science University (OHSU) [2].

Midodrine is not a cure for long-COVID and will not eradicate it from the body. Midodrine is used for symptom management associated with long-COVID.

References:

¹https://my.clevelandclinic.org/health/diseases/16560-postural-orthostatic-tachycardia-syndrome-pots

²https://www.ohsu.edu/sites/default/files/2021-04/Long-COVID-19-Clinical-Guidelines-English-April-21-2021.pdf