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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

  • 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)
  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. Calcium Channel Blockers
    3. ACE Inhibitors (e.g. Lisinopril)
    4. Hydralazine
    5. Dipyridamole (Persantine)
    6. Reserpine
  • 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. Parkinsonism agents (Levodopa-Carbidopa, Bromocriptine)
  2. Barbiturates
  3. MAO Inhibitors (e.g. Phenelzine)
  4. Tricyclic Antidepressants (e.g. Amitriptyline, Doxepin, Trazodone)
  5. Antipsychotics (e.g. Chlorpromazine, Clozapine, Thioridazine)
  6. Muscle relaxants (e.g. Baclofen, Cyclobenzaprine, Methocarbamol, Tizanidine)
  7. Tricyclic Antidepressants
  • Causes
  • Miscellaneous
  1. See Anticholinergic Medication
  2. Opioids (e.g. Morphine)
  3. Antidiabetes medications (e.g. Insulin)
  4. Phenothiazines
  5. Chemotherapy
    1. Vincristine
    2. Adriamycin (Doxorubicin)
  • References
  1. Gupta (2007) Am J Med 120(10): 841-7 [PubMed]
  2. Kim (2022) Am Fam Physician 105(1): 39-49 [PubMed]