Classic symptoms of nOH include orthostatic dizziness, lightheadedness, or the “feeling that you are about to black out.”1,2
Parkinson's disease (PD)
Multiple system atrophy (MSA)
Pure autonomic failure (PAF)
Non-diabetic autonomic neuropathy
Dopamine beta-hydroxylase deficiency
Impaired venous return
Considering that nOH is due to autonomic dysfunction and often associated with an underlying neurodegenerative disorder, restoring blood pressure (BP) to within a normal range in nOH patients might not be a feasible treatment goal. Instead, therapy should focus on symptom improvement.2,5,6,12
1. NORTHERA [package insert]. Deerfield, IL: Lundbeck. 2. Freeman R. N Engl J Med. 2008;358(6):615-624. 3. Goldstein DS, Sharabi Y. Circulation. 2009;119(1):139-146. 4. Bradley JG, Davis KA. Am Fam Physician. 2003;68(12):2393-2398. 5. Gibbons CH, Schmidt P, Biaggioni I, et al. J Neurol. 2017;264(8):1567-1582. 6. Freeman R, Wieling W, Axelrod FB, et al. Clin Auton Res. 2011;21(2):69-72. 7. Kaufmann H, Malamut R, Norcliffe-Kaufmann L, et al. Clin Auton Res. 2012;22(2):79-90. 8. Figueroa JJ, Basford JR, Low PA. Cleve Clin J Med. 2010;77(5):298-306. 9. Kaufmann H, Norcliffe-Kaufmann L, Palma JA. Expert Rev Cardiovasc Ther. 2015;13(8):875-891. 10. Isaacson SH, Skettini J. Vasc Health Risk Manag. 2014;10:169-176. 11. Goldstein DS, Pechnik S, Holmes C, et al. Hypertension. 2003;42(2):136-142. 12. Isaacson SH. Am J Manag Care. 2015;21(suppl 13):s258-s268.
Indications and Usage
NORTHERA (droxidopa) is indicated for the treatment of orthostatic dizziness, lightheadedness, 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. Effectiveness beyond 2 weeks of treatment has not been established. The continued effectiveness of NORTHERA should be assessed periodically.
Important Safety Information
WARNING: SUPINE HYPERTENSION
Monitor supine blood pressure prior to and during treatment and more frequently when increasing doses. Elevating the head of the bed lessens the risk of supine hypertension, and blood pressure should be measured in this position. If supine hypertension cannot be managed by elevation of the head of the bed, reduce or discontinue NORTHERA.
WARNINGS AND PRECAUTIONS
USE IN SPECIFIC POPULATIONS
For more information, please see the full Prescribing Information, including Boxed Warning for supine hypertension.