{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T02:47:29Z","timestamp":1776912449911,"version":"3.51.2"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T00:00:00Z","timestamp":1744761600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Midodrine has been primarily studied as an adjunctive oral therapy to reduce the need for vasopressors in intensive care units (ICU). Nonetheless, the available results evaluating midodrine as an adjuvant therapy in the treatment of septic shock are limited and inconclusive. This study aims to evaluate the efficacy of midodrine, specifically focusing on its effect on mortality outcomes in patients with septic shock.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This was an open\u2010label randomized controlled trial. Patients with septic shock (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009100) were randomized to either the control group, who received intravenous norepinephrine, or the midodrine group, who received intravenous norepinephrine and midodrine 10\u2009mg every 8\u2009h. The primary outcome was the 28\u2010day in\u2010hospital mortality. Secondary outcomes were 7\u2010day ICU mortality, average dose of norepinephrine, duration of intravenous norepinephrine, ICU length of stay (LOS), and in\u2010hospital LOS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The 28\u2010day mortality rate was 68% in the control group compared to 54% in the midodrine group (risk difference \u221214% (95% confidence interval (CI)) \u221232.9% to 4.9%). Similarly, the 7\u2010day ICU mortality rate was 56% in the control group and 42% in the midodrine group (risk difference \u221214% (95% CI \u221233.4% to 5.4%)). The average intravenous norepinephrine dose in the midodrine group was significantly lower compared to the control group (mean difference 0.06 (95% CI 0.01\u20130.11),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). However, midodrine did not have a significant impact on the duration of intravenous norepinephrine use (mean difference 0.66 (95% CI \u22120.56 to 1.88)). Midodrine did not significantly shorten the course of hospitalization. There was no significant difference in median ICU LOS between the control group and the midodrine group (4 vs. 5\u2009days, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The findings did not demonstrate a significant reduction in mortality with adjuvant midodrine use in the treatment of septic shock. Midodrine appears to reduce the need for vasopressors. However, our findings did not support that midodrine shortens the duration of vasopressor use nor the course of hospitalization for patients with septic shock.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/phar.70018","type":"journal-article","created":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T02:35:06Z","timestamp":1744857306000},"page":"264-272","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Efficacy of adjuvant use of midodrine in patients with septic shock: An open label randomized controlled trial"],"prefix":"10.1002","volume":"45","author":[{"given":"Nadine K.","family":"El\u2010Nagdy","sequence":"first","affiliation":[{"name":"Clinical Pharmacy and Pharmacy Practice Department, Faculty of Pharmacy Mansoura University  Mansoura Egypt"},{"name":"Department of Pharmacy Practice, Faculty of Pharmacy Delta University for Science and Technology  Gamasa Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4448-994X","authenticated-orcid":false,"given":"Noha O.","family":"Mansour","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy and Pharmacy Practice Department, Faculty of Pharmacy Mansoura University  Mansoura Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adel Al\u2010Hady Ahmed","family":"Diab","sequence":"additional","affiliation":[{"name":"Anesthesiology and Intensive Care Department, Faculty of Medicine Al\u2010Azhar University  New Damietta City Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8651-9385","authenticated-orcid":false,"given":"Moetaza M.","family":"Soliman","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy and Pharmacy Practice Department, Faculty of Pharmacy Mansoura University  Mansoura Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,4,16]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0287"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0289"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.4103\/lungindia.lungindia_54_16"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1476-5381.2011.01588.x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000005337"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15453"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.5152\/dcbybd.2011.12"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.13913"},{"key":"e_1_2_9_10_1","unstructured":"Wolters Kluwer Health IP PA.Midodrine. 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