• Alexander Garrard, Adam Wood, Dawn Sollee, and Patrick Aaronson.
• Upstate NY Poison Center, Emergency Medicine, Syracuse, USA. GARRARDA@upstate.edu
• Clin Toxicol (Phila). 2011 Dec 1;49(10):907-9.

BackgroundMinoxidil (Rogaine®) is a direct vasodilator that can cause significant toxicity when ingested. We report a case of ingestion of topical minoxidil [Rogaine® (Johnson & Johnson Healthcare Products, Division of McNeil-PPC, Inc)] resulting in refractory hypotension that was successfully managed with the oral α (1) agonist midodrine.Case ReportA 48-year-old male who ingested an eight ounce bottle of Rogaine® presented to the emergency department. The patient presented with a blood pressure of 57/45 mmHg and a pulse of 84 beats per minute. The patient received IV fluids and multiple vasopressors to maintain an adequate mean arterial pressure. Midodrine, an oral α (1) vasopressor, was added 10 hours post ingestion and was able to maintain an adequate mean arterial pressure. Over the next two days, midodrine was titrated down as his blood pressure returned to baseline.ConclusionMidodrine may serve as an additional option to treat toxicant induced hypotension.

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