Drugdocs | Northera®

Drug updated on 4/17/2024

Dosage Form	Capsules (oral: 100 mg, 200 mg, 300 mg)
Drug Class	Synthetic amino acid analogs
Ongoing and Completed Studies	ClinicalTrials.gov

Indication

Indicated for the treatment of orthostatic dizziness and light-headedness or the “feeling that you are about to black out” in adult patients with symptomatic neurogenic orthostatic hypotension (nOH) caused by primary autonomic failure (Parkinson's disease [PD], multiple system atrophy, and pure autonomic failure), dopamine beta-hydroxylase deficiency, and non-diabetic autonomic neuropathy.

Droxidopa (Northera) is indicated for the treatment of orthostatic dizziness and light-headedness in adult patients with symptomatic neurogenic orthostatic hypotension caused by primary autonomic failure, dopamine beta-hydroxylase deficiency, and non-diabetic autonomic neuropathy.
Two studies were reviewed to gather information about this drug.
The studies suggest that droxidopa has shown a positive impact on reducing symptoms of postural orthostatic tachycardia syndrome (POTS) and increasing orthostatic tolerance; however, more evidence is needed due to low sample sizes.
In terms of treating Orthostatic Hypotension (OH), droxidopa was mentioned as a potential option but without direct comparison regarding its effectiveness against other drugs like clonidine, beta-blockers, midodrine, and pyridostigmine.
For both POTS and OH conditions related to autonomic dysfunction such as Parkinson's disease or multiple system atrophy, among others, it appears that the choice between droxidopa or any other medication must consider individual patient profiles, including underlying etiologies and severity, which suggests an emphasis on a personalized medicine approach.
While there are no clear conclusions about the superiority or inferiority of Northera compared to other medications used for similar indications, these studies collectively suggest its role within a broader management strategy prioritizing patient quality of life and risk reduction over achieving perfect blood pressure control.

Document Title	Year	Source
Northera (droxidopa) prescribing information.	2019	Lundbeck, Deerfield, IL

Document Title	Year	Source
Choices and challenges with drug therapy in postural orthostatic tachycardia syndrome: a systematic review.	2023	Cureus
Prevention and management of supine hypertension in patients with orthostatic hypotension.	2021	American Journal of Therapeutics