title: Droxidopa in neurogenic orthostatic hypotension.
abstract: Neurogenic orthostatic hypotension (nOH) is a fall in blood pressure (BP) on standing due to reduced norepinephrine release from sympathetic nerve terminals. nOH is a feature of several neurological disorders that affect the autonomic nervous system, most notably Parkinson disease (PD), multiple system atrophy (MSA), pure autonomic failure (PAF), and other autonomic neuropathies. Droxidopa, an orally active synthetic amino acid that is converted to norepinephrine by the enzyme aromatic L-amino acid decarboxylase (dopa-decarboxylase), was recently approved by the FDA for the short-term treatment of nOH. It is presumed to raise BP by acting at the neurovascular junction to increase vascular tone. This article summarizes the pharmacological properties of droxidopa, its mechanism of action, and the efficacy and safety results of clinical trials.
authors.affiliation: Department of Neurology, New York University School of Medicine, New York, NY, USA.
authors.forename: Horacio
authors.initials: H
authors.lastname: Kaufmann
authors.forename: Lucy
authors.initials: L
authors.lastname: Norcliffe-Kaufmann
authors.forename: Jose-Alberto
authors.initials: JA
authors.lastname: Palma
mesh_terms: D001341:Autonomic Nervous System / Q000187:drug effects / Q000503:physiopathology; D001794:Blood Pressure / Q000187:drug effects; D015103:Droxidopa / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007024:Hypotension, Orthostatic / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D013566:Sympathomimetics / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D013566:Sympathomimetics; D015103:Droxidopa
keywords: L-DOPS; Parkinson disease; autonomic failure; autonomic neuropathy; blood pressure; catecholamines; dopamine-beta hydroxylase deficiency; multiple system atrophy; pure autonomic failure; syncope