Drug treatment of Orthostatic hypotension

With thanks to Professor Chris Mathias, Imperial College London

Volume expanders:

        Fludrocortisone - low dose, starting with 50 mcg nocte increasing the dose gradually every six weeks to a maximum of 200 mcg or 300 mcg nocte if required

        Flurbiprofen - a Non Steriodal Anti Inflammatory Drug may be used in conjunction with Fludrocortisone to enhance fluid retention

Adrenoreceptor agonists:

        Midodrine - post-ganglionic alpha agonist. Named patient basis, only, in UK

        Ephedrine - beta agonist. Use with care tds with last dose early evening

Specific targeting:

        Octreotide - for post-prandial hypotension

        Desmopressin - with Fludrocortisone if nocturnal polyuria

        Erythropoietin - for refractory anaemia in renal failure

 Last updated 19/01/2008