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Midodrine + pyridostigmine

Seoul National University Hospital · FDA-approved active Small molecule ✓ Verified May 2026

Midodrine + pyridostigmine is a Alpha-1 adrenergic agonist + acetylcholinesterase inhibitor combination Small molecule drug developed by Seoul National University Hospital. It is currently FDA-approved for Orthostatic hypotension. Also known as: Combination.

Midodrine and pyridostigmine together increase blood pressure and improve symptoms of orthostatic hypotension by enhancing sympathetic activation and acetylcholine availability.

Midodrine, a small molecule, is used in combination with pyridostigmine to treat conditions associated with spinal cord injury, such as autonomic dysreflexia, and to study baroreceptor integrity, sympathetic integrity, and vagal integrity. The combination of midodrine and pyridostigmine has been studied in clinical trials for its effects on blood pressure and cerebral blood flow in individuals with spinal cord injury.

At a glance

Generic nameMidodrine + pyridostigmine
Also known asCombination
SponsorSeoul National University Hospital
Drug classAlpha-1 adrenergic agonist + acetylcholinesterase inhibitor combination
TargetAlpha-1 adrenergic receptor; acetylcholinesterase
ModalitySmall molecule
Therapeutic areaCardiovascular
PhaseFDA-approved

Mechanism of action

Midodrine is an alpha-1 adrenergic agonist that directly increases peripheral vasoconstriction and blood pressure. Pyridostigmine is an acetylcholinesterase inhibitor that enhances parasympathetic tone and can improve blood pressure regulation through central and peripheral mechanisms. The combination is used to address orthostatic hypotension through complementary pathways.

Approved indications

Common side effects

Key clinical trials

Primary sources

Every claim on this page is sourced from regulatory or scientific primary sources. See our editorial policy for full methodology.

SourceUsed for
ClinicalTrials.govTrial enrolment, design, endpoints, results

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Frequently asked questions about Midodrine + pyridostigmine

What is Midodrine + pyridostigmine?

Midodrine + pyridostigmine is a Alpha-1 adrenergic agonist + acetylcholinesterase inhibitor combination drug developed by Seoul National University Hospital, indicated for Orthostatic hypotension.

How does Midodrine + pyridostigmine work?

Midodrine and pyridostigmine together increase blood pressure and improve symptoms of orthostatic hypotension by enhancing sympathetic activation and acetylcholine availability.

What is Midodrine + pyridostigmine used for?

Midodrine + pyridostigmine is indicated for Orthostatic hypotension.

Who makes Midodrine + pyridostigmine?

Midodrine + pyridostigmine is developed and marketed by Seoul National University Hospital (see full Seoul National University Hospital pipeline at /company/seoul-national-university-hospital).

Is Midodrine + pyridostigmine also known as anything else?

Midodrine + pyridostigmine is also known as Combination.

What drug class is Midodrine + pyridostigmine in?

Midodrine + pyridostigmine belongs to the Alpha-1 adrenergic agonist + acetylcholinesterase inhibitor combination class. See all Alpha-1 adrenergic agonist + acetylcholinesterase inhibitor combination drugs at /class/alpha-1-adrenergic-agonist-acetylcholinesterase-inhibitor-combination.

What development phase is Midodrine + pyridostigmine in?

Midodrine + pyridostigmine is FDA-approved (marketed).

What are the side effects of Midodrine + pyridostigmine?

Common side effects of Midodrine + pyridostigmine include Supine hypertension, Piloerection, Urinary retention, Headache, Tremor.

What does Midodrine + pyridostigmine target?

Midodrine + pyridostigmine targets Alpha-1 adrenergic receptor; acetylcholinesterase and is a Alpha-1 adrenergic agonist + acetylcholinesterase inhibitor combination.

Related

Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing