midodrine hydrochloride / Generic mfg. - LARVOL DELTA

EFFECT OF MIDODRINE ON SHORT TERM MORTALITY AND LIVER FUNCTION IN PATIENTS WITH CIRRHOSIS AND ASCITES: A SYSTEMATIC REVIEW AND META-ANALYSIS (UEGW 2026) - "Aims & A systematic search was conducted for randomized controlled trials comparing midodrine (with or without rifaximin) to standard medical therapy or albumin in cirrhotic patients with ascites. Midodrine is associated with significant improvements in both short-term mortality and liver function, as assessed by MELD score, in patients with cirrhosis and ascites. These findings support the consideration of midodrine as a therapeutic adjunct in selected patients. Further large-scale, multicenter trials are warranted to validate these results."

Retrospective data • Review • Fibrosis • Hepatology • Immunology • Liver Cirrhosis

Pulmonary Safety and Survival Outcomes of Terlipressin Versus Midodrine-Octreotide in Hepatorenal Syndrome: A Real-World Analysis (ACG 2026) - "After propensity score matching, 341 patients remained in each cohort. Respiratory failure rates were comparable between groups at 30 days (4.3% vs 5.6%; RR 0.76, 95% CI 0.370, 1.576), 60 days (6.9% vs 6.0%; RR 1.157, 95% CI 0.617, 2.171), and 90 days (7.7% vs 8.5%; RR 0.898, 95% CI 0.525, 1.536). Mortality remained high in both cohorts, occurring in 34.6% versus 31.2% of patients at 30 days, 42.5% versus 37.0% at 60 days, and 46.3% versus 39.6% at 90 days in the terlipressin and midodrineâoctreotide groups, respectively."

Clinical • Real-world • Real-world evidence • Acute Respiratory Distress Syndrome • Cardiovascular • Fibrosis • Hepatology • Immunology • Infectious Disease • Nephrology • Pneumonia • Pulmonary Embolism • Renal Disease • Respiratory Diseases • Septic Shock

When Ascites Is at Breaking Point: A Rare Case of Flood Syndrome (ACG 2026) - "The patient was discharged on hospital Day 6 with midodrine, furosemide, and spironolactone, given strict return precautions, and scheduled outpatient biweekly paracenteses with interventional radiology. In clinical cases where liver transplantation or TIPS are not options, multidisciplinary management of ascites and surgical intervention should be considered. Figure: Ulcerated focus at the most protruding portion of umbilical hernia."

Clinical • Cardiovascular • Fibrosis • Gastroenterology • Hematological Disorders • Hepatology • Immunology • Infectious Disease • Liver Cirrhosis • Septic Shock • Thrombosis

Terlipressin vs MOA for HRS-AKI: Comparable Mortality but Higher Respiratory Risk in a National Matched Cohort (ACG 2026) - "Baseline characteristics were well balanced after 1:1 propensity matching (Table 1). Demographics, MELD-related laboratory values, and rates of hepatic and cardiopulmonary decompensation were comparable between groups. Mortality rates were similar between Terlipressin and MOA at 30 days (35.86% vs."

Acute Kidney Injury • Hepatology • Nephrology • Renal Disease • Respiratory Diseases

Small Bowel Pseudo-Obstruction Mimicking Ogilvie Syndrome: A Case of Extreme Intestinal Dilation in a Post-Colectomy Patient (ACG 2026) - "Neostigmine was contraindicated due to chronic hypotension on midodrine...Methylnaltrexone was administered adjunctively, though evidence for PAMORAs in postoperative ileus remains limited...Figure: Abdominal CT and pelvis without contrast showing diffuse small bowel dilation up to 9cm without mechanical transition point. Figure: Abdominal radiograph confirming persistent dilation measuring 9.3cm."

Clinical • Hypotension • Infectious Disease • Septic Shock

Persistent Diarrhea and Orthostatic Hypotension; Uncovering the Impact of Diabetic Autonomic Neuropathy (ACG 2026) - "Gastroenterology consultation initially recommended incorporating high-dose cholestyramine, scheduled l omotil, imodium, and empiric rifaximin for possible small intestine bacterial overgrowth...Her blood pressure remained labile despite volume repletion, prompting the initiation of midodrine & fludrocortisone for support...Furthermore, in this patient, first and second line therapies were ineffective and led to longstanding diarrhea with severe volume loss. Earlier initiation of octreotide may be warranted in similar patient populations."

Cardiovascular • Chronic Kidney Disease • Diabetes • Diabetic Neuropathy • Hypotension • Metabolic Disorders • Renal Disease • GAST

Association of Midodrine Use With Renal and Transplant Outcomes in Patients With Hepatorenal Syndrome-Chronic Kidney Disease: A Propensity Score-Matched Analysis (ACG 2026) - "At 180 days, mortality was similar between the control and midodrine cohorts (34.2% vs. 33.0%; OR 1.06, 95% CI 0.91â1.22; p = 0.458). Dialysis initiation occurred less frequently in the midodrine cohort (2.4% vs."

Clinical • Acute Kidney Injury • Chronic Kidney Disease • Fibrosis • Hepatology • Immunology • Nephrology • Renal Disease • Transplantation

Marked Hyperlipasemia Without Acute Pancreatitis in Cirrhosis Complicated by Hepatorenal Syndrome (ACG 2026) - "Case Description/ A 65-year-old man with alcohol-related cirrhosis and IgA nephropathy on budesonide and mycophenolate presented with nausea, vomiting, poor appetite, and vague abdominal discomfort one day after large-volume paracentesis with removal of 7 liters of ascitic fluid...The patient was treated with albumin, octreotide, and midodrine...Misdiagnosis as pancreatitis may lead to unnecessary testing and inappropriate aggressive fluid administration that could worsen ascites and circulatory dysfunction. Careful clinical correlation with imaging findings and hemodynamic context is essential to avoid diagnostic error and guide appropriate management."

Acute Kidney Injury • Fibrosis • Gastrointestinal Disorder • Glomerulonephritis • Hepatology • IgA Nephropathy • Immunology • Inflammation • Liver Cirrhosis • Nephrology • Pancreatitis • Renal Disease

When the Dam Breaks: Flood Syndrome Complicated by Klebsiella Pneumoniae Carbapenemase-Producing Enterobacter Cloacae Bacteremia in Decompensated Cirrhosis (ACG 2026) - "Postoperatively, he developed ileus requiring nasogastric decompression and oliguric AKI (peak creatinine 4.99) managed with albumin, midodrine, and octreotide...Meropenem-vaborbactam and vancomycin were initiated...Multidisciplinary coordination is essential for optimizing outcomes. Figure: Abdominal wall, status post umbilical hernia repair"

Cardiovascular • Fibrosis • Gastroenterology • Hepatology • Immunology • Infectious Disease • Liver Cirrhosis • Pneumonia • Portal Hypertension • Septic Shock

Prevalence of spotted fever group rickettsiae infections in ticks and among high-risk populations in the southern margin of the Gurbantunggut Desert in Xinjiang Uygur Autonomous Region (PubMed, Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi) - "Multiple SFGR species are detected in H. asiaticum ticks sampled from the southern margin of the Gurbantunggut Desert, Xinjiang Uygur Autonomous Region, where there is a potential risk of local transmission of spotted fever rickettsiosis."

Journal • Infectious Disease

Improved outcomes for patients with autonomic movement disorders originally evaluated for psychogenic non-epileptiform spells. (PubMed, Front Neurol) - "14 of 17 patients were started on at least one medication for symptom management, including fludrocortisone, pyridostigmine, midodrine, and propranolol, with 8 of 17 on combination therapy. Patients presenting with abnormal seizure-like movements confirmed as non-epileptic after further evaluation should be assessed for autonomic dysfunction. Treatment targeting orthostatic hypotension may help alleviate these abnormal movements."

Journal • CNS Disorders • Epilepsy • Hypotension • Movement Disorders

EFFICACY AND SAFETY OF ADJUNCTIVE MIDODRINE FOR VASOPRESSOR-DEPENDENT SHOCK IN THE ICU: A PROBABILISTIC BAYESIAN META-ANALYSIS (CHEST 2026) - No abstract available

Retrospective data • Critical care • Mood Disorders • Thermal Injury

Investigating the Impact of Food Induced Fluid Viscosity on Disintegration and Dissolution of Immediate Release Midodrine HCl Tablet. (PubMed, AAPS J) - "In contrast, co-administered water enabled tablet swelling and disintegration, leading to complete drug release within 15 min, which is more consistent with the in vivo PK data under fed conditions. These findings may help refine in vitro dissolution conditions to better mimic fed-state."

Journal • Cerebral Hemorrhage • Gastrointestinal Disorder

MIDOH-HF-P: Midodrine in Heart Failure With Reduced Ejection Fraction With Hypotension (clinicaltrials.gov) - P2/3 | N=56 | Recruiting | Sponsor: Ottawa Heart Institute Research Corporation | Not yet recruiting ➔ Recruiting

Enrollment open • Cardiovascular • Congestive Heart Failure • Heart Failure • Hypotension

Midodrine To Enable Guideline-directed Medical Therapy In Hypotension-limited HFrEF: A Systematic Review Of Efficacy And Clinical Outcomes [Poster no. 275] (HFSA 2026) - No abstract available

Clinical • Clinical data • Review • Cardiovascular • Hypotension

Comparative Safety of Midodrine versus Fludrocortisone in Hypotensive Heart Failure with Reduced Ejection Fraction: A Propensity-Matched Real-World Analysis (AHA 2026) - "Abstract is embargoed at this time."

Clinical • Real-world • Real-world evidence • Cardiovascular • Congestive Heart Failure • Heart Failure

Real-World Experience of Midodrine in Hospital Setting in Pulmonary Arterial Hypertension. (PubMed, CHEST Pulm) - "Patients on midodrine during hospitalization received higher doses of epoprostenol (P < .001), treprostinil (P < .05), and selexipag (P < .05). This study, to our knowledge the first large-scale analysis of PAH data, investigated the use of midodrine in hospitalized patients with PAH. In this single-center study, we share real-world experience of using midodrine to mitigate systemic hypotension, thereby facilitating the uptitration of PAH-targeted therapies."

Journal • Real-world evidence • Cardiovascular • Congestive Heart Failure • Heart Failure • Hypertension • Hypotension • Pulmonary Arterial Hypertension • Pulmonary Disease • Respiratory Diseases

Recurrent Syncope Due to Orthostatic Hypotension Following Lateral Medullary Infarction: A Case Report. (PubMed, Intern Med) - "Sequential treatment with midodrine, fludrocortisone, and droxidopa resolved the symptoms. Serial head-up tilt testing suggested a partial improvement in the orthostatic hemodynamic responses. Orthostatic hypotension should be considered in patients with lateral medullary infarction and positional symptoms, and serial head-up tilt testing may help document any changes in the orthostatic hemodynamic response."

Journal • Ataxia • Cardiovascular • Hypotension • Movement Disorders

Postural Orthostatic Tachycardia Syndrome (POTS): A Review. (PubMed, JAMA) - "Pharmacological therapies should be individualized and may include β-blockers, ivabradine, midodrine, fludrocortisone, and pyridostigmine, although evidence supporting many therapeutic interventions is limited by small studies and lack of large, randomized trials. POTS is a chronic autonomic disorder associated with functional impairment and reduced quality of life that is diagnosed based on characteristic orthostatic symptoms in the absence of orthostatic hypotension after excluding alternative causes of sinus tachycardia. Treatment involves nonpharmacological measures (such as increased fluid and sodium intake), lower-body compression garments, structured exercise training, and individualized pharmacological therapy."

Journal • Anorexia • Cardiomyopathy • Cardiovascular • CNS Disorders • Cognitive Disorders • Constipation • Endocrine Disorders • Epstein-Barr Virus Infections • Fatigue • Gastroenterology • Gastrointestinal Disorder • Heart Failure • Hematological Disorders • Hypotension • Infectious Disease • Influenza • Musculoskeletal Pain • Nephrology • Novel Coronavirus Disease • Oncology • Pain • Pulmonary Disease • Renal Disease • Respiratory Diseases • Sleep Disorder • Solid Tumor

Persistent Cognitive Dysfunction in Postural Orthostatic Tachycardia Syndrome: A Scoping Review of Neural Mechanisms, Interventions, and Critical Research Gaps. (PubMed, Cureus) - "Current therapies, including beta-blockers, ivabradine, midodrine, exercise, salt and fluid loading, compression garments, cognitive behavioral therapy (CBT), and sleep management, rarely use cognition as a primary endpoint. Findings suggest that persistent cognitive dysfunction in POTS may reflect incomplete alignment between neurological mechanisms and cardiovascular-centered care, requiring validated cognitive outcomes and multimodal trials combining biological, autonomic, and rehabilitative interventions."

Journal • Review • Cardiovascular • Cognitive Disorders • Immunology • Inflammation

Treatment of Orthostatic Hypotension in SCI (clinicaltrials.gov) - P4 | N=25 | Recruiting | Sponsor: James J. Peters Veterans Affairs Medical Center | Trial completion date: Jun 2026 ➔ Jun 2027 | Trial primary completion date: Jun 2026 ➔ Jun 2027

Trial completion date • Trial primary completion date • CNS Disorders • Hypotension • Orthopedics

The Role of Nitric Oxide in Chronic Liver Disease: A Review. (PubMed, J Clin Transl Hepatol) - "Therapies including statins, phosphodiesterase-5 inhibitors, and midodrine have been developed to restore NO homeostasis but have achieved only partial success in modulating NO production, bioavailability, and distribution. The aim of this review is to update the understanding of the mechanisms and effects of NO dysregulation in cirrhosis as they relate to current and future therapeutic options."

Journal • Review • Cardiovascular • Fibrosis • Hepatology • Hypertension • Immunology • Nephrology • Portal Hypertension • Pulmonary Arterial Hypertension • Pulmonary Disease • Renal Disease • Respiratory Diseases

When Treatment Becomes the Trigger: Fludrocortisone-Associated Hypokalaemia in an Older Adult. (PubMed, Cureus) - "Following intravenous potassium replacement and discontinuation of fludrocortisone, with initiation of midodrine as an alternative therapy, the patient's potassium levels normalised and her symptoms improved. This case highlights the importance of medication review and regular electrolyte monitoring in older adults, particularly those receiving mineralocorticoid therapy."

Journal • Geriatric Disorders • Hypotension

Oral Albuterol for the Treatment of Rate-Dependent QT Prolongation and Polymorphic Ventricular Tachycardia. (PubMed, JACC Case Rep) - "Albuterol is an oral B1 agonist that may be repurposed for increasing heart rate in rate-related polymorphic VT, as in this case, and perhaps in cases of symptomatic sinus bradycardia."

Journal • Cardiovascular • Critical care • Ventricular Tachycardia

Evaluation of Terlipressin and In-Hospital Mortality in the Treatment of Hepatorenal Syndrome-Acute Kidney Injury (HRS-AKI). (PubMed, Ann Pharmacother) - "Terlipressin appears to effectively improve renal function and in-hospital mortality in patients with HRS-AKI compared with MO. Terlipressin may be used as a first-line treatment for HRS-AKI or after a trial of MO based on the study's results."

Journal • Acute Kidney Injury • Fibrosis • Hepatology • Immunology • Nephrology • Renal Disease