Big T asked
Can you take 0.1 mg fludrocortisone with 5 mg midodrine?
Answer
The combination of fludrocortisone and midodrine is considered a moderate interaction. Both of these drugs, Fludrocortisone and midodrine, have potential to increase one's blood pressure and intraocular pressure. They are generally not recommended together unless under the supervision of a physician and determined to be medically necessary.
Fludrocortisone is a corticosteroid and is used as replacement therapy for people who have either primary or secondary adrenocortical insufficiency in Addison's disease and/or for people who have salt-wasting adrenogenital syndrome.
It provides synthetic aldosterone for people who can't produce sufficient aldosterone. Side effects from fludrocortisone can include salt and water retention which can lead to hypertension (increased blood pressure), edema, and other heart problems.
Midodrine is a medication that is indicated for people who suffer with orthostatic hypotension (blood pressure that drops when one rises from sitting/laying to standing). It acts on receptors which work on the blood vessels to raise blood pressure.
As mentioned, both medications can raise blood pressure. High blood pressure is of concern because when uncontrolled, it can lead to stroke. Additionally, the combination of these two medications can increase ocular pressure (pressure in the eyes) which becomes a risk factor for glaucoma.
There are some situations when the concurrent use of fludrocortisone and midodrine is recommended. In one study, patients who were experiencing fatigue and who had high renin and high aldosterone levels were evaluated. The rise of these hormones was believed to be a reaction to low blood volume because of the body's inability to retain salt. The study found that treating these patients with a combination of both medications mentioned (in addition to salt tablets) improved patient's chief complaints of fatigue and dizziness on standing as well as improved mental functioning. So, while the use of both medications typically is not recommended, it is evident their joint use can be acceptable in certain situations.
If you have two separate physicians prescribing these medications, please make sure that they both know your entire medication history so they can properly treat you. Always consult your physician if you are experiencing new symptoms.
