Droxidopa

Droxidopa is approved for use in the treatment of orthostatic hypotension, intradialytic hypotension (IDH; hemodialysis-induced hypotension), dizziness, and amyloid polyneuropathy. as well as NOH associated with multiple system atrophy (MSA), familial amyloid polyneuropathy (FAP), and pure autonomic failure (PAF). The drug is also used off-label in the treatment of freezing of gait in Parkinson's disease. ==Side effects==

With over 20years on the market, droxidopa has proven to have few side effects of which most are mild. The most common side effects reported in clinical trials include headache, dizziness, nausea, hypertension and fatigue. ==Pharmacology==

Droxidopa is a prodrug of norepinephrine used to increase the concentrations of these neurotransmitters in the body and brain. Droxidopa works by increasing the levels of norepinephrine in the peripheral nervous system (PNS), thus enabling the body to maintain blood flow upon and while standing. Droxidopa can also cross the blood–brain barrier (BBB) where it is converted to norepinephrine from within the brain. Increased levels of norepinephrine in the central nervous system (CNS) may be beneficial to patients in a wide range of indications. Droxidopa can be coupled with a peripheral aromatic L-amino acid decarboxylase inhibitor (AAADI) or DOPA decarboxylase inhibitor (DDC) such as carbidopa (Lodosyn) to increase central norepinephrine concentrations while minimizing increases of peripheral levels. ==Chemistry==

Droxidopa, also known as (–)-threo-3-(3,4-dihydroxyphenyl)-L-serine (L-DOPS), is a substituted phenethylamine and is chemically analogous to levodopa (L-3,4-dihydroxyphenylalanine; L-DOPA). Whereas levodopa functions as a precursor and prodrug to dopamine, droxidopa is a precursor and prodrug of norepinephrine. ==History==

Droxidopa was first described in the scientific literature by 1971. Droxidopa was developed by Sumitomo Pharmaceuticals for the treatment of hypotension, including NOH, Clinical trials A systematic review and meta-analysis conducted on clinical trials comparing the clinical use of droxidopa and midodrine have found that midodrine was more likely to cause supine hypertension than droxidopa in patients with NOH. Midodrine was also found to be slightly more effective at raising blood pressure but not statistically significantly. Chelsea Therapeutics obtained orphan 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. ==Society and culture==

Names Droxidopa is the generic name of the drug and its and . Brand names of droxidopa include Dops and Northera. ==Research==

Droxidopa alone and in combination with carbidopa has been studied in the treatment of attention deficit hyperactivity disorder (ADHD). Droxidopa was under development for the treatment of ADHD, chronic fatigue syndrome, and fibromyalgia, but development for these indications was discontinued. ==See also==