midodrine (Takeda)

Midodrine is a small molecule prodrug that is enzymatically hydrolyzed to its active metabolite, desglymidodrine. Desglymidodrine acts as a selective agonist of the alpha-1 adrenergic receptor, triggering the contraction of vascular smooth muscle in both the arterial and venous systems. This action increases peripheral vascular resistance and enhances venous return to the heart. While midodrine is primarily indicated for the treatment of symptomatic orthostatic hypotension, it has been investigated under the development code BX1514M for its potential to alleviate symptoms in patients with hypertrophic cardiomyopathy (HCM). In this context, the drug is hypothesized to reduce left ventricular outflow tract obstruction (LVOTO) by increasing venous return and improving ventricular filling, thereby decreasing the pressure gradient across the outflow tract during contraction.

Brand names

GutronProAmatineOrvaten

Other names

midodrine hydrochloridedesglymidodrine