Meta-analysis of the safety and efficacy of droxidopa for neurogenic orthostatic hypotension

Abstract

Droxidopa is a safe and effective drug for the short-term management of NOH symptoms. However, current evidence is insufficient to confirm the efficacy of droxidopa for long-term use. Therefore, further studies with increased sample size are needed.

Initiating droxidopa for neurogenic orthostatic hypotension in a patient with Parkinson disease

“…Starting this patient on droxidopa, which is a synthetic precursor of NE [1, 4], is a reasonable option at this stage. Additionally, given that this patient needs to nap several times daily, there is a mechanistic hypothesis that increasing NE levels in the CNS may potentially improve other non-motor symptoms in PD [2], although no large studies have been performed to confirm this.…”

Defining successful treatment of neurogenic orthostatic hypotension with droxidopa in a patient with multiple system atrophy

“…At that time, orthostatic blood pressure (BP) readings confirmed that she was experiencing a large fall in BP (170/87 mmHg supine to 110/65 mmHg after 3-min of standing-up) while her heart rate (HR) increased by only 10 beats per minute or less; therefore, she was diagnosed with neurogenic orthostatic hypotension (nOH). Droxidopa was initiated at 100 mg on a modified three times daily (TID) schedule (taken on awakening, at midday, and at least 3–4 h prior to bedtime) [1, 3]. Her droxidopa dose was up-titrated every 24–48 h by 100 mg on the modified TID schedule.…”

Differential diagnosis of suspected neurogenic orthostatic hypotension in a patient with Parkinson disease

“…Droxidopa is FDA-approved for the treatment of symptomatic nOH in PD and has demonstrated favorable tolerability [2, 3]. A potential side effect of droxidopa is sHTN.…”