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Medication Causes of Orthostatic Hypotension

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Medication Causes of Orthostatic Hypotension, Orthostatic Hypotension due to Medication, Drug-Induced Orthostatic Hypotension, Drug-Induced Hypotension, Drug-Induced Syncope, Medication-Induced Syncope

  • See Also
  1. Orthostatic Hypotension
  • Causes
  • Cardiac Medications
  1. Methyldopa
  2. Clonidine
  3. Antiarrhythmic medications (esp. Type Ia such as Quinidine)
    1. Digitalis (Atrioventricular Block, Ventricular Tachycardia)
  4. Alpha adrenergic blockers (e.g. Prazosin, Doxazosin, Terazosin)
    1. Less common with Selective Alpha-1a Antagonist (e.g. Tamsulosin)
  5. Beta Blockers (e.g. Atenolol, Metoprolol)
  6. Alpha-Beta Blockers (Carvedilol, Labetalol)
  7. Diuretics (e.g. Furosemide) due to multiple mechanisms (Hypovolemia, Hypokalemia, Hypomagnesemia)
  8. Vasodilator medications
    1. Nitrates (Nitroglycerin)
    2. Hydralazine
    3. Dipyridamole (Persantine)
    4. Reserpine
  9. Other agents that are not associated with significant Orthostatic Hypotension
    1. Calcium Channel Blockers
    2. ACE Inhibitors (e.g. Lisinopril)
  • Causes
  • Genitourinary Medications
  1. Phosphodiesterase type 5 inhibitors (e.g. Sildenafil or Viagra)
  2. Anticholinergics (e.g. Oxybutynin or Ditropan)
  3. Flibanserin (Addyi)
  • Causes
  • Neuropsychiatric Agents
  1. Tricyclic Antidepressants (e.g. Amitriptyline, Doxepin, Trazodone)
  2. Parkinsonism agents (Levodopa-Carbidopa, Bromocriptine)
  3. Barbiturates
  4. MAO Inhibitors (e.g. Phenelzine)
  5. Antipsychotics (e.g. Chlorpromazine, Clozapine, Thioridazine)
    1. Second generation Antipsychotics are also associated with Orthostatic Hypotension
  6. Muscle relaxants (e.g. Baclofen, Cyclobenzaprine, Methocarbamol, Tizanidine)
  • Causes
  • Miscellaneous
  1. See Anticholinergic Medication
  2. Opioids (e.g. Morphine)
  3. SGLT2 Inhibitor (Diabetes Mellitus)
  4. Phenothiazines
  5. Chemotherapy
    1. Vincristine
    2. Adriamycin (Doxorubicin)
  • References
  1. Bhanu (2021) PLoS Med 18(11):e1003821 +PMID: 34752479 [PubMed]
  2. Gupta (2007) Am J Med 120(10): 841-7 [PubMed]
  3. Kim (2022) Am Fam Physician 105(1): 39-49 [PubMed]