Droxidopa Is a Prescription Medication That Treats Neurogenic Orthostatic Hypotension (nOH)

Droxidopa is a synthetic amino acid that your body converts into norepinephrine — a chemical that helps regulate blood pressure. It's sold under the brand name Northera and is the only medication in its class specifically FDA-approved for neurogenic orthostatic hypotension (nOH).

What Is Droxidopa?

• Generic name: Droxidopa
• Brand name: Northera
• Drug class: Norepinephrine precursor
• Manufacturer: Lundbeck
• FDA approval: February 2014
• Controlled substance: No
• Generic available: Yes — generic Droxidopa capsules are available from multiple manufacturers

What Is Droxidopa Used For?

Droxidopa is FDA-approved to treat neurogenic orthostatic hypotension (nOH) — a condition where blood pressure drops significantly when you stand up, causing symptoms like:

• Dizziness or lightheadedness
• Feeling like you might faint or black out
• Unsteadiness when standing
• Blurred vision upon standing

nOH is caused by damage to the autonomic nervous system and is commonly associated with:

• Parkinson's disease
• Multiple system atrophy (MSA)
• Pure autonomic failure (PAF)

Droxidopa specifically targets the neurogenic form of orthostatic hypotension, not other causes of low blood pressure. For how it compares to other treatments, see alternatives to Droxidopa.

How Is Droxidopa Taken?

Droxidopa comes as oral capsules in three strengths:

• 100mg
• 200mg
• 300mg

Dosing schedule:

• Starting dose: 100mg three times daily
• When to take: Morning, midday, and late afternoon (at least 3 hours before bedtime)
• Titration: Your doctor will increase the dose by 100mg three times daily every 24-48 hours
• Maximum dose: 600mg three times daily

Important: The last dose must be taken at least 3 hours before bedtime to reduce the risk of supine hypertension (high blood pressure while lying down).

Capsules can be taken with or without food. Swallow whole — do not crush or open the capsules.

Who Should Not Take Droxidopa?

Droxidopa may not be right for everyone. Tell your doctor if you:

• Have uncontrolled high blood pressure
• Are allergic to Droxidopa or any inactive ingredients in the capsule
• Take MAO inhibitors or sympathomimetic medications (see drug interactions)
• Are pregnant or breastfeeding

Your doctor will weigh the benefits against the risks for your specific situation.

How Much Does Droxidopa Cost?

Droxidopa pricing varies significantly:

• Brand Northera (retail): Approximately $2,721 for 90 capsules
• Generic Droxidopa with GoodRx coupon: As low as $36.90
• Generic with SingleCare: Approximately $72.04
• With insurance: Varies by plan; most require prior authorization. Copays may range from $30 to $200+ depending on tier.

Generic Droxidopa represents up to 98% savings over brand. For full details on how to save, see our savings guide.

How Does Droxidopa Work?

Droxidopa is a norepinephrine precursor. Your body converts it into norepinephrine, a neurotransmitter that constricts blood vessels and raises blood pressure. In patients with nOH, the nervous system can't produce enough norepinephrine on its own, so Droxidopa supplements it. For a detailed explanation, see How Does Droxidopa Work?

Final Thoughts

Droxidopa is an important treatment option for patients living with neurogenic orthostatic hypotension. While it's a specialty medication that can be costly at retail price, generic availability and discount programs have made it more accessible than ever. Work with your neurologist to determine if Droxidopa is right for you, and use tools like Medfinder to find it in stock near you.