Severe and refractory hypotension after intentional minoxidil overdose: a case report

We describe a case of minoxidil overdose which led to a prolonged distributive shock. Although this was a case of combined trauma presenting with self-inflicted lacerations and intentional overdose via ingestion of minoxidil-finasteride topical spray and non-steroidal anti-inflammatory drugs (NSAIDs), we believe the hypotension encountered was due to minoxidil's effects and not exsanguination. In conjunction with poison control, our patient was successfully managed with phenylephrine, vasopressin, midodrine, and several liters of IV hydration despite prolonged refractory hypotension.