Objectives: To assess the use of Midodrine among patients with orthostatic hypotension and withdrawal vasopressin in King Abdulaziz Medical City (KAMC), demonstrate the effectiveness and safety of Midodrine and detect side effects to provide clear evidence of the efficacy and safety of the drug.

Methods: A retrospective cohort study was done in King Abdulaziz Medical City in Riyadh (Saudi Arabia). The study targeted adult patients who suffered from hypotension between January 2015 and January 2018. The data was extracted using the BESTCare system.

Results: A total of 173 patients were included (55.5% male and 44.5% female). The mean age of the study participants was 67.34 ± 16.0 years. The differences in patients’ parameters before and after midodrine administration were detected and analyzed. The mean difference in hemoglobin (g/l) level was significantly changed before (94.97 ± 21.9) and after (90.84 ± 20.4) the use of Midodrine (p=0.031). However, there were no significant changes in the level of the other parameters before and after the use of Midodrine. The mean dose of Midodrine was 5.3 mg, with mean treatment duration of 41.5 days, and mean hospitalization of 28.7 days. For the medication history, 8% of patients were on betablockers (n=97), 5%were on diuretics (n=64), and 2% were on calcium channel blockers (n=19).

Conclusion: Our data suggest that the administration of Midodrine does not affect patients’ hemodynamics significantly; however, it has a notable effect on decreasing hemoglobin levels