Comprehensive medication guide to Droxidopa including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$30–$200+ copay; prior authorization required, specialty tier common
Estimated Cash Pricing
$2,721 retail (brand Northera); as low as $36.90 with GoodRx coupon (generic)
Medfinder Findability Score
30/100
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Droxidopa (brand name Northera) is an FDA-approved medication for neurogenic orthostatic hypotension (nOH) — a condition where blood pressure drops significantly when standing, causing dizziness, lightheadedness, or fainting. It is associated with Parkinson's disease, multiple system atrophy, and pure autonomic failure. Droxidopa was approved by the FDA in February 2014 and is manufactured by Lundbeck.
Droxidopa is a norepinephrine precursor — a synthetic amino acid that your body converts into norepinephrine using the enzyme DOPA decarboxylase. Norepinephrine causes blood vessels to constrict, raising blood pressure. In patients with nOH, nerve damage reduces natural norepinephrine production, and Droxidopa supplements this deficit.
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100mg capsules
starting dose
200mg capsules
intermediate dose
300mg capsules
higher dose
Droxidopa scores 30 out of 100 on the Medfinder findability scale, making it one of the harder medications to locate. As a specialty drug for neurogenic orthostatic hypotension, it's not stocked at most retail pharmacies. Brand Northera is distributed primarily through specialty pharmacies, though generic Droxidopa has improved availability somewhat. Prior authorization requirements and high cost create additional access barriers.
Droxidopa is most commonly prescribed by neurologists, particularly those specializing in movement disorders or autonomic dysfunction. Cardiologists who treat syncope and autonomic specialists at academic medical centers may also prescribe it. Some primary care physicians will manage refills once a specialist initiates therapy.
No. Droxidopa is not classified as a controlled substance by the DEA. However, it is a prescription-only medication that typically requires prior authorization from insurance companies before coverage is approved.
Boxed Warning: Supine hypertension (high blood pressure when lying down). Patients should elevate the head of the bed and take the last dose at least 3 hours before bedtime.
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Midodrine
Alpha-1 agonist, FDA-approved for orthostatic hypotension. Widely available generic, much cheaper ($10-$30/month). Often tried first.
Fludrocortisone
Mineralocorticoid used off-label. Increases blood volume by retaining sodium and water. Very affordable.
Pyridostigmine
Cholinesterase inhibitor, off-label for mild nOH. May be better tolerated but less effective for severe cases.
Prefer Droxidopa? We can find it.
Sympathomimetics
moderate(pseudoephedrine, phenylephrine) — risk of dangerously high blood pressure
MAO inhibitors
moderatemay enhance norepinephrine effects
COMT inhibitors
moderate(Entacapone, Tolcapone) — may alter metabolism
Carbidopa
moderatemay reduce conversion to norepinephrine
Blood pressure medications
moderatemay counteract effects
Droxidopa is a uniquely targeted medication for patients with neurogenic orthostatic hypotension. While finding it can be challenging due to specialty distribution and prior authorization requirements, generic availability has dramatically reduced costs. Use Medfinder to find pharmacies with stock near you.
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