When using capillary electrophoresis (CE) for the analysis of biological samples, it is often necessary to employ techniques to overcome peak-broadening that results from having a high-conductivity sample matrix. To improve the concentration detection limits and separation efficiency of cationic pharmaceuticals in CE, pH-mediated acid stacking was performed to electrofocus the sample, improving separation sensitivity for the analyzed cations by 60-fold. However, this method introduces a large titrated acid plug into the capillary. To overcome the limitations this low-conductivity plug poses to stacking, the plug was removed prior to the separation step by applying reverse pressure to force it out of the anode of the capillary. Employing this technique allows for roughly twice the volume of sample to be injected. A maximum sample injection time of 240 s was attainable with baseline peak resolution compared to a maximum sample injection time of 120 s without reverse pressure, leading to a twofold decrease in the limits of detection of the analytes used. Separation efficiency overall is also improved when utilizing the reverse pressure step. For example, a 60 s sample injection time results in 94 000 theoretical plates as compared to 60 500 theoretical plates without reverse pressure. This reverse-pressure method was used for detection and quantitation of several cationic pharmaceuticals that were prepared in Ringer's solution to simulate microdialysis sampling conditions.