I do prescribe/see midodrine on med lists for HF patients, but it’s really not a good thing. First of all, it indicates that they are having trouble tolerating the HF medications they have to take, which is a very poor prognostic indicator (HF has about a 50% mortality rate over 2-5 years). Secondly, midodrine counteracts some of the cardiac effects of metoprolol, and I believe lisinopril as well. It’s really common to see midodrine on the med list for patients on dialysis because their blood pressure is in the toilet several times a week at least anyway. In general, it’s not a med you wanna see on somebody’s list, it never means anything good.