Indications for NORTHERA:
Symptomatic neurogenic orthostatic hypotension (NOH) caused by primary autonomic failure (Parkinson's disease, multiple system atrophy, and pure autonomic failure), dopamine beta-hydroxylase deficiency, and non-diabetic autonomic neuropathy.
Swallow whole. Take with or without food. Initially 100mg three times daily in the morning, midday, and late afternoon (≥3hrs prior to bedtime). Titrate in increments of 100mg three times daily every 24–48hrs; max 600mg three times daily.
May cause or exacerbate supine hypertension. Monitor BP (supine and head-elevated sleeping positions) prior to initiating and after increasing the dose; reduce dose or discontinue if supine hypertension persists. Monitor for symptoms of neuroleptic malignant syndrome; observe carefully during dose changes or when concomitant levodopa is reduced abruptly or discontinued, especially if receiving neuroleptics. May exacerbate ischemic heart disease, arrhythmias, CHF. Discontinue if hypersensitivity reactions occur. Allergic reactions (tartrazine). Reevaluate periodically. Severe renal impairment (GFR <30mL/min): limited data. Pregnancy. Nursing mothers: not recommended.
Concomitant drugs that increase BP (eg, norepinephrine, ephedrine, midodrine, and triptans); increased risk of supine hypertension. Concomitant dopa-decarboxylase inhibitors: may need to adjust droxidopa dose. Avoid concomitant non-selective MAOIs or linezolid.
Headache, dizziness, nausea, hypertension, falls, UTI, syncope; hyperpyrexia, confusion.