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Overview: Droxidopa is commonly used to treat low blood pressure due to nervous system problems. It is thought to help treat low blood pressure by causing your blood vessels to constrict (narrow). Common side effects include headache, dizziness, and nausea. The main serious side effect is high blood pressure, particularly upon lying down.

Uses

What is droxidopa used for?

Droxidopa is commonly used to treat people with low blood pressure upon standing (orthostatic hypotension) that is caused by conditions affecting the nervous system.

Droxidopa may also be used for other conditions as determined by your healthcare provider.

How does droxidopa work (mechanism of action)?

Droxidopa is thought to help treat low blood pressure by causing your blood vessels to constrict (narrow). 

How is droxidopa supplied (dosage forms)?

Brands and other names

  • Northera

Dosage forms and strengths

  • 100 mg oral capsules
  • 200 mg oral capsules
  • 300 mg oral capsules

How should I store droxidopa?

Droxidopa should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.

Side Effects

What are the most common side effects of droxidopa?

The most common side effects of droxidopa are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • Headache
  • Dizziness
  • Nausea
  • High blood pressure (see below) 

There may be other side effects of droxidopa that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of droxidopa?

While less common, the most serious side effects of droxidopa are described below, along with what to do if they happen.

High Blood Pressure (Hypertension). Droxidopa may cause dangerous increases in your blood pressure, particularly when you are lying down. If you measure your blood pressure and the top number (systolic) is 180 mm Hg or higher or the bottom number (diastolic) is 120 mm Hg or higher, get medical attention right away. Increases in blood pressure may not be noticeable, but look out for and tell your healthcare provider right away if you have any of the following symptoms of severely high blood pressure.

  • Sudden severe headache
  • Chest pain
  • Dizziness or confusion
  • Trouble breathing
  • Nausea or vomiting
  • Blurry or other changes to vision
  • Anxiety
  • Buzzing in the ears
  • Nosebleed
  • Feeling of skipped heartbeats

Severe Allergic Reactions. Droxidopa may cause allergic reactions, which can be serious. Stop taking droxidopa and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Warnings & Precautions

Who should not use droxidopa?

Allergies to Ingredients. People who are allergic to any of the following should not take droxidopa.

  • Northera
  • Droxidopa
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific droxidopa products they stock.

What should I know about droxidopa before using it?

Do not take droxidopa unless it has been prescribed to you by a healthcare provider. Take it as prescribed.

Take droxidopa consistently with or without food. 

Do not share droxidopa with other people, even if they have the same condition as you. It may harm them.

Keep droxidopa out of the reach of children.

Your healthcare provider will likely check your blood pressure, standing and lying down, before starting droxidopa and while you are taking it. This is to watch for any dangerous increases in blood pressure. 

Lying down after taking droxidopa can raise your blood pressure. Take your last dose of the day at least three hours before bedtime to prevent high blood pressure while sleeping.

Elevating your head and upper body while lying down lowers your risk of high blood pressure. You should rest and sleep with your upper body elevated and check your blood pressure in this position. Talk to your healthcare provider about what steps to take if your blood pressure gets too high when lying down.

Do not stop taking droxidopa without talking to your healthcare provider. Stopping too quickly may cause serious side effects. Call your healthcare provider right away if you have any of the following symptoms.

  • High fever
  • Muscle stiffness or rigidity, where it is hard to move
  • Changes in your breathing or heart rate
  • Increased sweating
  • Confusion

What should I tell my healthcare provider before using droxidopa?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if droxidopa is right for you.

In particular, make sure that you discuss any of the following

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

  • Heart disease
  • Problems with your nervous system
  • Kidney problems

Other Medicines and Supplements. Droxidopa may interact with other medicines and supplements. Before taking droxidopa, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how droxidopa could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. 

Breastfeeding. It is not known if droxidopa passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should stop breastfeeding or stop droxidopa.

Interactions

Does droxidopa interact with foods or drinks?

There are no known interactions between droxidopa and foods or drinks.

It is unknown if drinking alcohol will affect droxidopa. The risk of dizziness may be increased if you drink alcohol while taking droxidopa. 

Does droxidopa interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking droxidopa.

  • A decongestant that you spray in your nose or take by mouth, such as pseudoephedrine or  phenylephrine, which is used to treat nasal congestion
  • A triptan, such as sumatriptan (Imitrex and others), eletriptan (Relpax), and others, which is a medicine commonly used to treat migraines
  • An ergot, such as ergotamine (Ergomar) or dihydroergotamine (Migranal or Trudhesa), which is a medicine used to treat migraine
  • A monoamine oxidase inhibitor (MAOI), which is a medicine usually used for depression or Parkinson’s disease
  • Midodrine, which is a medicine for low blood pressure 
  • A medicine for Parkinson’s disease
  • A medicine for high blood pressure

This may not be a complete list of medicines that can interact with droxidopa. Always check with your healthcare provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much droxidopa?

If you or someone else has used too much droxidopa, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of droxidopa?

If you miss a dose, skip the missed dose and only take the next dose. Do not take double or extra doses.