Using Midodrine During Illness
20-year-old female, weighing 125 pounds and standing at 5'6" Diagnosed with hypermobile Ehlers-Danlos Syndrome (hEDS), orthostatic hypotension, and Postural Orthostatic Tachycardia Syndrome (POTS). Currently on 2.5mg of midodrine as needed, along with 150mg of Zoloft. Today, I awakened feeling rather unwell, displaying only a sore throat and significant tenderness in my left lymph node, perhaps indicating a viral infection without fever. My dysautonomia exacerbates significantly during bouts of illness. As it stands, I can hardly sit up in bed without the sensation of impending faintness. Accompanying symptoms include migraines, tinnitus, and temporary vision loss. My blood pressure measures at 112/80 while seated, with a heart rate of 85 beats per minute. However, upon standing, my blood pressure plummets to 88/60 and my heart rate spikes to 135 beats per minute. Would taking midodrine provide relief when transitioning from sitting to standing? Alternatively, could it pose risks during my current illness? Should I remain in bed until I recover? Any guidance would be appreciated!
Answers (1)
7/28/2025, 8:10:45 PM
OpenHealth AI
It’s understandable to feel concerned when experiencing significant symptoms related to your dysautonomia during an illness. Your situation involves a delicate balance regarding the use of midodrine, which is often prescribed to help with orthostatic hypotension, especially following standing up.
Key Points:
- Midodrine can help maintain blood pressure when transitioning from sitting to standing, but using it during an active illness, particularly viral infections, requires caution.
- Your symptoms suggest that your body is under stress, and taking additional medication at this time might pose risks, including potential increases in heart rate or further dehydration.
Explanation: Midodrine works by constricting blood vessels to increase blood pressure, which may benefit your orthostatic hypotension. However, in the context of an illness, especially with symptoms like a sore throat, lymphadenopathy, and dizziness, your body may be more sensitive to changes in medication. Given that your heart rate and blood pressure fluctuate significantly, using midodrine could potentially exacerbate your tachycardia or lead to other issues during an illness where rest and hydration are critical.
Next Steps:
- Rest: Stay in bed as much as possible and avoid sudden changes in position. This will help manage your symptoms and prevent fainting spells.
- Hydration: Increase your fluid intake, focusing on electrolytes (e.g., oral rehydration solutions) to support your body's needs, particularly given your history of dysautonomia.
- Monitor Symptoms: Keep track of any worsening of your symptoms. If you experience severe symptoms like persistent dizziness, chest pain, or fainting, these would indicate the need for immediate attention.
- Avoid Midodrine for Now: Given your current health status, it may be wise to hold off on taking midodrine until you feel more stable or consult your healthcare provider about it.
- Comfort Measures: Manage headaches and migraines with supportive care (like a cool compress or rest in a dark, quiet room) without additional medications unless directed by your doctor.
These steps aim to prioritize your well-being and comfort while navigating this illness. Should your symptoms worsen or not improve in a few days, consider reaching out to a healthcare professional for more tailored advice.
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