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Droxidopa: A Review of Its Use in Symptomatic Neurogenic Orthostatic Hypotension

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Abstract

The norepinephrine prodrug droxidopa (NORTHERA™) is approved in the US for the treatment of orthostatic dizziness, lightheadedness, or the ‘feeling that you are about to black out’ in adults with symptomatic neurogenic orthostatic hypotension associated with primary autonomic failure (e.g. Parkinson’s disease, multiple system atrophy or pure autonomic failure), dopamine β-hydroxylase deficiency or nondiabetic autonomic neuropathy. This article reviews the clinical efficacy and tolerability of droxidopa in symptomatic neurogenic orthostatic hypotension, as well as summarizing its pharmacological properties. Oral droxidopa was effective in the shorter-term treatment of patients with symptomatic neurogenic orthostatic hypotension, with improvements seen in symptoms, the impact of symptoms on daily activities and standing systolic blood pressure. More data are needed to confirm the longer-term efficacy of droxidopa. Droxidopa was generally well tolerated, although patients should be monitored for supine hypertension.

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Disclosure

The preparation of this review was not supported by any external funding. Gillian Keating is a salaried employee of Adis/Springer. During the peer review process, the manufacturer of the agent under review was offered an opportunity to comment on this article. Changes resulting from comments received were made by the author on the basis of scientific and editorial merit.

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    Gillian M. Keating

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  1. Gillian M. Keating
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Correspondence to Gillian M. Keating.

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The manuscript was reviewed by: S.H. Fox, Movement Disorder Clinic, University of Toronto, Toronto Western Hospital, Toronto, ON, Canada; S. Grill, Parkinson’s and Movement Disorders Center of Maryland, Elkridge, MD, USA; P.A. Low, Mayo Clinic, Rochester, MN, USA.

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Keating, G.M. Droxidopa: A Review of Its Use in Symptomatic Neurogenic Orthostatic Hypotension. Drugs 75, 197–206 (2015). https://doi.org/10.1007/s40265-014-0342-1

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