Droxidopa, also known asL-threo-dihydroxyphenylserine (L-DOPS) and sold under the brand namesNorthera andDops among others, issympathomimeticmedication which is used in the treatment ofhypotension (low blood pressure) and for other indications.[2][3] It is takenby mouth.[2]
With over 20years on the market, droxidopa has proven to have fewside effects of which most are mild. The most common side effects reported in clinical trials include headache, dizziness, nausea, hypertension and fatigue.[11][12][13]
Droxidopa, also known as (–)-threo-3-(3,4-dihydroxyphenyl)-L-serine (L-DOPS), is asubstituted phenethylamine and is chemically analogous tolevodopa (L-3,4-dihydroxyphenylalanine;L-DOPA). Whereas levodopa functions as a precursor and prodrug todopamine, droxidopa is a precursor and prodrug ofnorepinephrine.[citation needed]
Droxidopa was developed by Sumitomo Pharmaceuticals for thetreatment ofhypotension, including NOH,[7] and NOH associated with variousdisorders such as MSA, FAP, and PD, as well as IDH. The drug has been used inJapan and some surroundingAsian areas for theseindications since 1989.[7]
Asystematic review andmeta-analysis conducted onclinical trials comparing the clinical use of droxidopa andmidodrine have found that midodrine was more likely to causesupine hypertension than droxidopa in patients with NOH. Midodrine was also found to be slightly more effective at raising blood pressure but not statistically significantly.[15]
Chelsea Therapeutics obtainedorphan drug status (ODS) for droxidopa in the US for NOH, and that of which associated with PD, PAF, and MSA. In 2014, Chelsea Therapeutics was acquired by Lundbeck along with the rights to droxidopa which was launched in the US in Sept 2014.[16]
Droxidopa is thegeneric name of the drug and itsINNTooltip International Nonproprietary Name andJANTooltip Japanese Accepted Name.[17] Brand names of droxidopa includeDops andNorthera.[17][2]
^abRobson RD (June 1971). "Modification of the cardiovascular effects of L-dopa in anesthetized dogs by inhibitors of enzymes involved in catecholamine metabolism".Circ Res.28 (6):662–670.doi:10.1161/01.res.28.6.662.PMID4325846.
^abcdMathias CJ (March 2008). "L-dihydroxyphenylserine (Droxidopa) in the treatment of orthostatic hypotension: the European experience".Clinical Autonomic Research.18 (Supplement 1):25–29.doi:10.1007/s10286-007-1005-z.PMID18368304.S2CID29861644.
^Calandra-Buonaura G, Doria A, Lopane G, et al. (February 2016). "Pharmacodynamics of a low subacute levodopa dose helps distinguish between multiple system atrophy with predominant Parkinsonism and Parkinson's disease".Journal of Neurology.263 (2):250–256.doi:10.1007/s00415-015-7961-7.PMID26566913.S2CID189866517.
^Chen JJ, Han Y, Tang J, Portillo I, Hauser RA, Dashtipour K (December 2018). "Standing and Supine Blood Pressure Outcomes Associated With Droxidopa and Midodrine in Patients With Neurogenic Orthostatic Hypotension: A Bayesian Meta-analysis and Mixed Treatment Comparison of Randomized Trials".The Annals of Pharmacotherapy.52 (12):1182–1194.doi:10.1177/1060028018786954.PMID29972032.S2CID49674644.
