Eligibility and Criteria

Inclusion Criteria

1. Age > 18 years
2. Ongoing vasopressor support (i.e., norepinephrine ≥0.05 mcg/kg/min, epinephrine ≥ 0.05 mcg/kg/min, vasopressin ≥0.04 U/min or phenylephrine ≥0.1 mcg/kg/min)
3. Decreasing vasopressor dose(s) (i.e., current dose less than peak dose(s)

Exclusion Criteria

1. Greater than 24 hours from peak vasopressor dose
2. Contraindication to enteral medications
3. Previously received midodrine in last 7 days
4. Expected death or anticipated withdrawal of life-sustaining therapies in next 24 hours
5. Pregnancy
6. Known allergy or other contraindication to midodrine
7. Treating clinician does not believe enrolment would be in the best interest of the patient