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. Author manuscript; available in PMC: 2023 Jan 1.
Published in final edited form as: Am J Med. 2021 Aug 18;135(1):24–31. doi: 10.1016/j.amjmed.2021.07.030

Table 2.

Management of the hospitalized patient with orthostatic hypotension

1. Remove factors that cause or contribute to orthostatic hypotension Dehydration, otherwise asymptomatic urinary infections, medications:
Alpha1- blockers (carvedilol, tamsulosin, trazodone)
Central sympatholytics (clonidine, tizanidine)
Vasodilators (sildenafil, nitrates)
Diuretics
Amitriptyline, Nortriptyline
2. Avoid bedrest Deconditioning and pressure diuresis worsens orthostatic hypotension.
3. Rule out postprandial hypotension Measure BP before and 30 min after a meal.
If present, treat with acarbose 50–100 mg before meals.
4. Conservative Countermeasures Avoid standing quickly, standing motionless & straining during defecation.
Abdominal compression (binder) while upright.
8–16 oz oral bolus.
5. Pressor agents (Table 3) Use as part of rehab, given prior to upright activities, never if patient is to remain supine. Titrate dose based on orthostatic vitals taken before and ∼1 hour after administration.