Book contents
- Frontmatter
- Contents
- List of icons
- Preface
- Acknowledgements
- 1 Acetazolamide
- 2 Alemtuzumab
- 3 Almotriptan
- 4 Alteplase
- 5 Amantadine
- 6 Amifampridine
- 7 Amitriptyline
- 8 Apixaban
- 9 Apomorphine
- 10 Aprepitant
- 11 Aripiprazole
- 12 Armodafinil
- 13 Aspirin (Acetylsalicylic Acid)
- 14 Azathioprine
- 15 Baclofen
- 16 Benztropine
- 17 Bevacizumab
- 18 Botulinum Toxin Type A
- 19 Botulinum Toxin Type B
- 20 Bromocriptine
- 21 Bupropion
- 22 Carbamazepine
- 23 Carisoprodol
- 24 Carmustine
- 25 Chlorpromazine
- 26 Citalopram
- 27 Clobazam
- 28 Clonazepam
- 29 Clonidine
- 30 Clopidogrel
- 31 Clozapine
- 32 Corticotropin
- 33 Cyclobenzaprine
- 34 Cyclophosphamide
- 35 Cyclosporine (Ciclosporin)
- 36 Cyproheptadine
- 37 Dabigatran Etexilate
- 38 Dalfampridine
- 39 Dantrolene
- 40 Desvenlafaxine
- 41 Dexamethasone
- 42 Dextromethorphan/Quinidine
- 43 Diazepam
- 44 Diclofenac
- 45 Dihydroergotamine
- 46 Dimethyl Fumarate
- 47 Dipyridamole and Aspirin
- 48 Donepezil
- 49 Droperidol
- 50 Droxidopa
- 51 Duloxetine
- 52 Edoxaban
- 53 Edrophonium
- 54 Eletriptan
- 55 Entacapone
- 56 Escitalopram
- 57 Eslicarbazepine Acetate
- 58 Ethosuximide
- 59 Everolimus
- 60 Ezogabine
- 61 Felbamate
- 62 Fingolimod
- 63 Flunarizine
- 64 Frovatriptan
- 65 Gabapentin
- 66 Galantamine
- 67 Glatiramer Acetate
- 68 Guanfacine
- 69 Haloperidol
- 70 Heparin
- 71 Indomethacin
- 72 Interferon-Β
- 73 Intravenous Immunoglobulin (Ivig)
- 74 Lacosamide
- 75 Lamotrigine
- 76 Levetiracetam
- 77 Levodopa and Carbidopa
- 78 Levomilnacipran
- 79 Lidocaine
- 80 Lithium
- 81 Mannitol
- 82 Meclizine
- 83 Memantine
- 84 Metaxalone
- 85 Methocarbamol
- 86 Methotrexate
- 87 Methylergonovine
- 88 Metoclopramide
- 89 Mexiletine
- 90 Milnacipran
- 91 Mirtazapine
- 92 Mitoxantrone
- 93 Modafinil
- 94 Mycophenolate Mofetil
- 95 Nabiximols
- 96 Naratriptan
- 97 Natalizumab
- 98 Netupitant/Palonosetron
- 99 Nimodipine
- 100 Nortriptyline
- 101 Olanzapine
- 102 Ondansetron
- 103 Oxcarbazepine
- 104 Penicillamine
- 105 Perampanel
- 106 Phenobarbital
- 107 Phenytoin and Fosphenytoin
- 108 Pizotifen
- 109 Pramipexole
- 110 Prednisone
- 111 Pregabalin
- 112 Primidone
- 113 Prochlorperazine
- 114 Promethazine
- 115 Propranolol
- 116 Pyridostigmine
- 117 Quetiapine
- 118 Quinine Sulfate
- 119 Ramelteon
- 120 Rasagiline
- 121 Reserpine
- 122 Riluzole
- 123 Rituximab
- 124 Rivaroxaban
- 125 Rivastigmine
- 126 Rizatriptan
- 127 Ropinirole
- 128 Rotigotine Transdermal System
- 129 Rufinamide
- 130 Selegiline
- 131 Sodium Oxybate
- 132 Sumatriptan
- 133 Suvorexant
- 134 Tasimelteon
- 135 Temozolomide
- 136 Teriflunomide
- 137 Tetrabenazine
- 138 Tiagabine
- 139 Timolol
- 140 Tizanidine
- 141 Topiramate
- 142 Trientine Hydrochloride
- 143 Trihexyphenidyl
- 144 Valproic Acid
- 145 Venlafaxine
- 146 Verapamil
- 147 Vigabatrin
- 148 Vilazodone
- 149 Vortioxetine Hydrobromide
- 150 Warfarin
- 151 Zolmitriptan
- 152 Zonisamide
- List of Abbreviations
- Index by Drug Name
- Index by Use
- Index by Class
50 - Droxidopa
Published online by Cambridge University Press: 06 October 2020
- Frontmatter
- Contents
- List of icons
- Preface
- Acknowledgements
- 1 Acetazolamide
- 2 Alemtuzumab
- 3 Almotriptan
- 4 Alteplase
- 5 Amantadine
- 6 Amifampridine
- 7 Amitriptyline
- 8 Apixaban
- 9 Apomorphine
- 10 Aprepitant
- 11 Aripiprazole
- 12 Armodafinil
- 13 Aspirin (Acetylsalicylic Acid)
- 14 Azathioprine
- 15 Baclofen
- 16 Benztropine
- 17 Bevacizumab
- 18 Botulinum Toxin Type A
- 19 Botulinum Toxin Type B
- 20 Bromocriptine
- 21 Bupropion
- 22 Carbamazepine
- 23 Carisoprodol
- 24 Carmustine
- 25 Chlorpromazine
- 26 Citalopram
- 27 Clobazam
- 28 Clonazepam
- 29 Clonidine
- 30 Clopidogrel
- 31 Clozapine
- 32 Corticotropin
- 33 Cyclobenzaprine
- 34 Cyclophosphamide
- 35 Cyclosporine (Ciclosporin)
- 36 Cyproheptadine
- 37 Dabigatran Etexilate
- 38 Dalfampridine
- 39 Dantrolene
- 40 Desvenlafaxine
- 41 Dexamethasone
- 42 Dextromethorphan/Quinidine
- 43 Diazepam
- 44 Diclofenac
- 45 Dihydroergotamine
- 46 Dimethyl Fumarate
- 47 Dipyridamole and Aspirin
- 48 Donepezil
- 49 Droperidol
- 50 Droxidopa
- 51 Duloxetine
- 52 Edoxaban
- 53 Edrophonium
- 54 Eletriptan
- 55 Entacapone
- 56 Escitalopram
- 57 Eslicarbazepine Acetate
- 58 Ethosuximide
- 59 Everolimus
- 60 Ezogabine
- 61 Felbamate
- 62 Fingolimod
- 63 Flunarizine
- 64 Frovatriptan
- 65 Gabapentin
- 66 Galantamine
- 67 Glatiramer Acetate
- 68 Guanfacine
- 69 Haloperidol
- 70 Heparin
- 71 Indomethacin
- 72 Interferon-Β
- 73 Intravenous Immunoglobulin (Ivig)
- 74 Lacosamide
- 75 Lamotrigine
- 76 Levetiracetam
- 77 Levodopa and Carbidopa
- 78 Levomilnacipran
- 79 Lidocaine
- 80 Lithium
- 81 Mannitol
- 82 Meclizine
- 83 Memantine
- 84 Metaxalone
- 85 Methocarbamol
- 86 Methotrexate
- 87 Methylergonovine
- 88 Metoclopramide
- 89 Mexiletine
- 90 Milnacipran
- 91 Mirtazapine
- 92 Mitoxantrone
- 93 Modafinil
- 94 Mycophenolate Mofetil
- 95 Nabiximols
- 96 Naratriptan
- 97 Natalizumab
- 98 Netupitant/Palonosetron
- 99 Nimodipine
- 100 Nortriptyline
- 101 Olanzapine
- 102 Ondansetron
- 103 Oxcarbazepine
- 104 Penicillamine
- 105 Perampanel
- 106 Phenobarbital
- 107 Phenytoin and Fosphenytoin
- 108 Pizotifen
- 109 Pramipexole
- 110 Prednisone
- 111 Pregabalin
- 112 Primidone
- 113 Prochlorperazine
- 114 Promethazine
- 115 Propranolol
- 116 Pyridostigmine
- 117 Quetiapine
- 118 Quinine Sulfate
- 119 Ramelteon
- 120 Rasagiline
- 121 Reserpine
- 122 Riluzole
- 123 Rituximab
- 124 Rivaroxaban
- 125 Rivastigmine
- 126 Rizatriptan
- 127 Ropinirole
- 128 Rotigotine Transdermal System
- 129 Rufinamide
- 130 Selegiline
- 131 Sodium Oxybate
- 132 Sumatriptan
- 133 Suvorexant
- 134 Tasimelteon
- 135 Temozolomide
- 136 Teriflunomide
- 137 Tetrabenazine
- 138 Tiagabine
- 139 Timolol
- 140 Tizanidine
- 141 Topiramate
- 142 Trientine Hydrochloride
- 143 Trihexyphenidyl
- 144 Valproic Acid
- 145 Venlafaxine
- 146 Verapamil
- 147 Vigabatrin
- 148 Vilazodone
- 149 Vortioxetine Hydrobromide
- 150 Warfarin
- 151 Zolmitriptan
- 152 Zonisamide
- List of Abbreviations
- Index by Drug Name
- Index by Use
- Index by Class
Summary
THERAPEUTICS
Brands
• Northera
Generic?
• No
Class
• Catecholamine analog
Commonly Prescribed for
(FDA approved in bold)
• Treatment of symptomatic neurogenic orthostatic hypotension (orthostatic dizziness, lightheadedness, syncope) in adult patients caused by primary autonomic failure (Parkinson's disease [PD], multiple system atrophy, pure autonomic failure, familial amyloid polyneuropathy), dopamine β-hydroxylase deficiency, and non-diabetic autonomic neuropathy
• Freezing of gait in PD
• Postural tachycardia syndrome (POTS)
• Prevention of orthostasis in hemodialysis patients
• Fibromyalgia
• Attention deficit hyperactivity disorder
• Chronic fatigue
How the Drug Works
• It is a synthetic catecholamino acid analog that is directly metabolized by dopa-decarboxylase to increase the concentrations of norepinephrine and epinephrine throughout the body. It also crosses the BBB and exerts its pharmacological effects within the CNS. Peripherally, it increases blood pressure by inducing peripheral arterial and venous vasoconstriction. It induces small and transient rises in plasma norepinephrine
• The contribution of other actions of droxidopa to its pharmacological effect is not well understood
How Long Until It Works
• Few days
If It Works
• May continue for a longer time, although no available study on treatment more than 2 weeks so far
If It Doesn't Work
• Correct any treatable underlying disorders
• Volume expansion: high-salt diet, increased fluid intake, fluorohydrocortisone
• Vasoconstriction: desmopressin (vasopressin analog), midodrine (α1 agonist)
Best Augmenting Combos for Partial Response or Treatment-Resistance
• Orthostasis: volume expansion and vasoconstriction
• POTS: volume expansion and vasoconstriction, exercise, cognitive behavioral therapy, propranolol, SNRIs, pyrostigmine
• Fibromyalgia: TCAs, SNRI, aerobic exercise, cognitive behavioral therapy
Tests
• None
ADVERSE EFFECTS (AEs)
How the Drug Causes AEs
• Elevated norepinephrine concentration
Notable AEs
• Headache, dizziness, nausea , supine hypertension, fatigue
Life-Threatening or Dangerous AEs
• Allergic reaction
• Neuroleptic malignant syndrome mimics (hyperpyrexia and confusion)
• May exacerbate existing ischemic heart disease, arrhythmias, and congestive heart failure
Weight Gain
• Unusual
- Type
- Chapter
- Information
- Essential NeuropharmacologyThe Prescriber's Guide, pp. 186 - 188Publisher: Cambridge University PressPrint publication year: 2015