A practical guide for providers on helping patients locate Droxidopa (Northera) in stock, navigate specialty pharmacies, and overcome common access barriers.
Droxidopa (brand name Northera) is one of only two FDA-approved medications specifically for neurogenic orthostatic hypotension (nOH) — the other being Midodrine. Despite its clinical importance for patients with Parkinson's disease, multiple system atrophy, and pure autonomic failure, finding Droxidopa in stock can be a frustrating experience for patients and providers alike.
The reasons are straightforward: Droxidopa is a specialty medication with a small patient population, limited pharmacy distribution, high retail cost ($2,721 for brand), and mandatory prior authorization for most insurance plans. These factors combine to create a medication that's technically available but practically difficult to obtain quickly.
In 2026, Droxidopa availability breaks down as follows:
The good news: generic availability has meaningfully improved access compared to when Northera was the only option.
Unless there's a clinical reason for brand-name Northera, prescribing generic Droxidopa (with "substitution permitted") gives pharmacies flexibility and patients cost savings. Generic Droxidopa with a GoodRx coupon can be as low as $36.90 versus $2,721 for brand.
Don't wait for the pharmacy to flag the PA requirement. Submit prior authorization proactively using CoverMyMeds, which connects electronically with most health plans. Key documentation to include:
Direct your patients — or your office staff — to Medfinder for Providers to search for pharmacies with Droxidopa currently in stock. This eliminates the cycle of calling pharmacy after pharmacy that wastes everyone's time.
Cost is the most common reason patients abandon Droxidopa prescriptions. Proactively offer:
For a complete breakdown, see our savings guide.
If Droxidopa is unavailable or unaffordable, be ready with alternatives:
See our detailed alternatives guide.
If patients have been stable on brand Northera, a switch to generic Droxidopa is generally seamless — the active ingredient, dosage forms, and strengths are identical. Monitor blood pressure at the first follow-up after switching to confirm equivalent response.
While Droxidopa is not currently listed on the FDA drug shortage list, its limited distribution and niche patient population create persistent access challenges that function similarly to a shortage. The shortage update for providers covers the broader context.
Your patients with neurogenic orthostatic hypotension depend on Droxidopa for their safety and quality of life. The medication exists, the generics exist, and the assistance programs exist — but navigating the system requires proactive effort from the prescribing team. By building PA submission, pharmacy-finding, and financial assistance into your prescribing workflow, you can dramatically reduce the time between writing the prescription and the patient taking their first dose.
For real-time pharmacy availability, visit Medfinder for Providers.
You focus on staying healthy. We'll handle the rest.
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