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Droxidopa is an orally active synthetic amino acid precursor of norepinephrine, classified as a vasopressor and alpha/beta adrenergic agonist. It is primarily used to treat symptomatic neurogenic orthostatic hypotension (nOH) in adults with conditions such as Parkinson’s disease, multiple system atrophy, pure autonomic failure, dopamine beta-hydroxylase deficiency, or non-diabetic autonomic neuropathy. Droxidopa works by being converted via decarboxylation to norepinephrine both peripherally and centrally (after crossing the blood-brain barrier), thereby increasing norepinephrine levels. This leads to vasoconstriction through activation of alpha-adrenergic receptors and increased cardiac output via beta-adrenergic receptor stimulation[1][3][4]. The drug was developed by Sumitomo Pharma and is marketed under the brand name Northera.
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