Midodrine

Summary

Midodrine (CHEMBL1201212) is an approved small-molecule prodrug (ATC C01CA17); indicated across 8 conditions including cardiovascular disorder and hypotensive disorder.

At a glance

• Status: Approved (max clinical phase 4)
• Modality: Small molecule
• ATC class: C01CA17
• Indications: 8 conditions
• Clinical trials: 76
• Chemistry: 254.28 Da · C12H18N2O4

Identifiers

Drug identity and classification

Field	Value
ChEMBL ID	CHEMBL1201212
Name	Midodrine
Type	Small molecule
Max phase	4
FDA approved	yes
PubChem CID	4195
ChEBI	CHEBI:6933
ATC	C01CA17
Molecular formula	C12H18N2O4
Molecular weight	254.28
InChIKey	PTKSEFOSCHHMPD-UHFFFAOYSA-N

SMILES: COC1=CC(=C(C=C1)OC)C(CNC(=O)CN)O

IUPAC name: 2-amino-N-[2-(2,5-dimethoxyphenyl)-2-hydroxyethyl]acetamide

ChEBI definition: An aromatic ether that is 1,4-dimethoxybenzene which is substituted at position 2 by a 2-(glycylamino)-1-hydroxyethyl group. A direct-acting sympathomimetic with selective α-adrenergic agonist activity, it is used (generally as its hydrochloride salt) as a peripheral vasoconstrictor in the treatment of certain hypotensive states. The main active moiety is its major metabolite, deglymidodrine.

Pharmacological roles (ChEBI): prodrug, α-adrenergic agonist, sympathomimetic agent, vasoconstrictor agent.

Also known as: Midodrina, Midodrine, ST 1085, ST-1085, midodrine, MIDODRINE, MIDODRINE HYDROCHLORIDE

Parent form; salt/anhydrous children: CHEMBL1200461

Patent coverage: 2,773 distinct patent families (5,482 SureChEMBL compound mentions), from 2 matched compound structure(s). One matched structure accounts for 5,478 (100%) of the total. Mentions count patents naming the compound (not distinct inventions), so promiscuous / reference molecules inflate the mention figure — families are the dedup metric.

Targets

Targets

Broader ChEMBL bioactivity targets: 2 (assay-derived). Sample: Alpha-1A adrenergic receptor, Adenosine receptor A3.

Bioactivity

ChEMBL activities: 2 potent at pChembl ≥ 5 of 3 total. Top 30 by potency (10 = 0.1 nM, 6 = 1 µM):

Target	pChembl	Type	Value	Unit	Activity ID
ADRA1A	5.3	AC50	4990	nM	CHEMBL_ACT_25219361
ADRA1A	5.14	AC50	7300	nM	CHEMBL_ACT_25230345

Target pathways

No target-pathway data for this drug (no mapped target genes).

Indications & clinical

Indications

8 indications (1 at ChEMBL trial phase 4). Phase below is the highest clinical-trial phase recorded for this drug against each disease — not the molecule’s overall approval status (that is in the Summary).

Indication	Trial phase	MONDO	EFO
cardiovascular disorder	4	MONDO:0004995	EFO:0000319
hypotensive disorder	3	MONDO:0005468	EFO:0005251
toxic shock syndrome	3	MONDO:0001881	EFO:0006834
spinal cord injury	3	MONDO:0043797	MONDO:0043797
orthostatic hypotension	2	MONDO:0005469	EFO:0005252
hepatopulmonary syndrome	1	MONDO:0004694	EFO:1001346

2 further indication records had no mapped disease name (EFO/MeSH-only) or were duplicates, and are omitted.

Clinical trials

Total trials: 76.

Phase distribution

Phase	Trials
Not specified	25
PHASE4	18
PHASE2	10
PHASE3	8
PHASE1	7
PHASE2/PHASE3	4
PHASE1/PHASE2	3
EARLY_PHASE1	1

Top trials by phase / activity

NCT	Phase	Status	Title
NCT01456481	PHASE4	ACTIVE_NOT_RECRUITING	Assessment of Midodrine in the Prevention of Vasovagal Syncope: The Prevention of Syncope Trial IV
NCT05058612	PHASE4	RECRUITING	Midodrine for the Early Liberation of Vasopressor Support in the ICU (LIBERATE Multi-Site)
NCT05839652	PHASE4	RECRUITING	Treatment of Orthostatic Hypotension in SCI
NCT00046163	PHASE4	TERMINATED	A Phase IV Study in Subjects With Neurogenic Orthostatic Hypotension
NCT00046475	PHASE4	COMPLETED	A Study for Patients With Neurogenic Orthostatic Hypotension
NCT00108355	PHASE4	COMPLETED	Vasoconstrictors as Alternatives to Albumin After Large-Volume Paracentesis (LVP) in Cirrhosis
NCT00555880	PHASE4	COMPLETED	Study to Assess the Benefit of Midodrine in the Treatment of Patients With Neurogenic Orthostatic Hypotension
NCT00839358	PHASE4	COMPLETED	Effect of Midodrine and Albumine in the Prevention of Complications in Cirrhotic Patients Awaiting Liver Transplantation
NCT01822535	PHASE4	COMPLETED	Body Temperature in Persons With Tetraplegia When Exposed to Cold
NCT02308124	PHASE4	COMPLETED	Treatment and Prognosis of Neurogenic Orthostatic Hypotension : A Prospective Randomized Study
NCT02379156	PHASE4	COMPLETED	Thermoregulation and Cognition During Cool Ambient Exposure in Tetraplegia
NCT02771158	PHASE4	WITHDRAWN	Midodrine During Recovery From Septic Shock
NCT03080441	PHASE4	UNKNOWN	Minimization of Intradialytic Hypotension Using Cardiography-Guided Intervention
NCT03350659	PHASE4	COMPLETED	Efficacy and Safety of Midodrine and Atomoxetine for Neurogenic OH
NCT03911817	PHASE4	COMPLETED	Impact of Midodrine Administration on the Clinical Outcome of Septic Shock Patients
NCT04440085	PHASE4	UNKNOWN	RaGuS Trial by Postoperative Patients
NCT04489589	PHASE4	COMPLETED	Midodrine for the Early Liberation of Vasopressor Support in the ICU
NCT04668859	PHASE4	TERMINATED	Midodrine as Novel Treatment of Post-Cardiopulmonary Bypass Vasoplegic Syndrome
NCT06405555	PHASE2/PHASE3	NOT_YET_RECRUITING	Midodrine in Heart Failure With Reduced Ejection Fraction With Hypotension
NCT00240045	PHASE2/PHASE3	COMPLETED	The Use of Drugs to Improve Kidney Function in Patients With Liver and Kidney Dysfunction
NCT01531959	PHASE3	COMPLETED	Midodrine for the Treatment of Refractory Hypotension
NCT01707953	PHASE3	COMPLETED	Efficacy of Midodrine for the Prevention of Orthostatic Hypotension During Early Mobilization After Fast-track Hip Arthroplasty
NCT02173288	PHASE2/PHASE3	COMPLETED	Role of Midodrine and Tolvaptan in Patients With Cirrhosis With Refractory or Recurrent Ascites
NCT02307565	PHASE3	COMPLETED	Blood Pressure, Cerebral Blood Flow and Cognition in Spinal Cord Injury
NCT02919917	PHASE2/PHASE3	COMPLETED	Treatment of Post-SCI Hypotension
NCT02990546	PHASE3	WITHDRAWN	Midodrine in the Recovery Phase of Septic Shock
NCT03706053	PHASE3	TERMINATED	Midodrine Use in Septic Shock
NCT04595942	PHASE3	UNKNOWN	Midodrine and Fludrocortisone for Vasovagal Syncope
NCT04621617	PHASE3	UNKNOWN	Midodrine and Albumin in Patients With Refractory Ascites
NCT05240391	PHASE3	COMPLETED	Midodrine Versus Albumin for Prevention of Paracentesis Induced Circulatory Disturbance
NCT00262470	PHASE1/PHASE2	ACTIVE_NOT_RECRUITING	Treatment of Orthostatic Intolerance
NCT06319248	PHASE2	RECRUITING	MID-STEP (MIDodrine for Sepsis Treatment and Early vasoPressor Weaning) Trial
NCT00004268	PHASE2	COMPLETED	Phase II Study of Midodrine for Neurogenic Orthostatic Hypotension
NCT00227448	PHASE2	COMPLETED	Induced Hypertension for Acute Ischemic Stroke
NCT00426842	PHASE2	COMPLETED	A Dose Response Trial Using 5 and 10 Mg of Midodrine Hydrochloride
NCT00835224	PHASE2	COMPLETED	Safety and Efficacy of L-NAME and Midodrine to Increase MAP
NCT01587222	PHASE2	WITHDRAWN	Midodrine, Octreotide and Albumin: Impact on Renal Function of Patients With Liver Cirrhosis and Renal Failure
NCT02893553	PHASE2	COMPLETED	The Effects of Normalizing Blood Pressure on Cerebral Blood Flow in Hypotensive Individuals With Spinal Cord Injury
NCT03482297	PHASE1/PHASE2	COMPLETED	Automated Abdominal Binder for Orthostatic Hypotension
NCT04048707	PHASE2	WITHDRAWN	Angiotensin 2 for Hepatorenal Syndrome

Clinical evidence (CIViC)

No CIViC predictive evidence (expected for non-precision-medicine drugs).

Pharmacology

Pharmacogenomics

No CPIC/DPWG dosing guideline or drug-level clinical/variant annotations in PharmGKB for this molecule.

Related molecules

Related molecules

No competitor molecules sharing a primary target (ChEMBL phase ≥2 or PubChem drug-class).