droxidopa / Generic mfg. - LARVOL DELTA

Safety & Clinical Use of Droxidopa for Midodrine Augmentation in Vasopressor Weaning in Septic Shock (SCCM 2026) - "Droxidopa augmentation of midodrine for vasopressor weaning in septic shock appears feasible, as it was well tolerated and most patients were successfully weaned off IV vasopressors. Further studies are needed to evaluate the long-term impact of dual therapy on ICU lengths of stay and outcomes in patients requiring extended hospitalization."

Clinical • Cardiovascular • CNS Disorders • Hypotension • Infectious Disease • Septic Shock

Droxidopa in Critical Care: A Systematic Review of an Emerging Off-Label Practice (SCCM 2026) - "Droxidopa may assist in vasopressor weaning in ICU patients, but available evidence remains limited and heterogeneous. Further research is warranted."

Review • Cardiovascular • Critical care • Infectious Disease

Droxidopa Administration via Enteral Tube for Vasopressor Weaning in a Medical Intensive Care Unit (SCCM 2026) - "Droxidopa administration via enteral tube was not associated with significantly reduced efficacy or increased safety concerns after adjusting for confounders. Enteral administration may be a reasonable alternative in patients who cannot swallow capsules whole. However, differences in illness severity preclude definitive conclusions."

Cardiovascular • Critical care • Hypertension • Hypotension

Droxidopa for Facilitating Vasopressor Weaning in Persistent Hypotension (SCCM 2026) - "Midodrine is the most widely studied oral agent but has limited efficacy in decreasing vasopressor duration. In this retrospective analysis, initiation of droxidopa led to vasopressors discontinuation by day 7 in a small proportion of patients. Though droxidopa was well tolerated, larger comparative trials are warranted to elucidate its potential role in vasopressor weaning strategies."

Hypotension

RATES OF CICU AND MICU ADMISSION AND IN-HOSPITAL MORTALITY AMONG PATIENTS REQUIRING ORAL PRESSORS AND RAPID RESPONSE TEAM ACTIVATION WITHIN 24 HOURS OF ADMISSION (ACC 2026) - "Background: It is unclear if oral pressors like droxidopa and midodrine prevent cardiac and medical intensive care unit (CICU, MICU) admission after rapid response team (RRT) activation within 24 hours of hospital admission. Oral pressor use in patients with RRT within 24 hours of admission was associated with greater comorbidities, illness severity, and CICU/MICU consults. Similar CICU/MICU admission rates and greater IV pressor requirements after correcting for blood pressure suggests oral pressors do not prevent ICU admission and could delay needed escalation."

Clinical • Cardiovascular • Congestive Heart Failure • Heart Failure

REAL-WORLD COMPARATIVE OUTCOMES OF DROXIDOPA VS MIDODRINE IN OLDER ADULTS WITH ORTHOSTATIC HYPOTENSION (ACC 2026) - "In a large cohort of patients aged ≥65 years, droxidopa led to fewer acute care visits than midodrine with similar survival rates. This suggests droxidopa may lower expensive, high-acuity encounters without affecting survival or increasing side effects. Key limitations include the retrospective design and lack of data on supine hypertension."

Clinical • Real-world • Real-world evidence • CNS Disorders • Congestive Heart Failure • Diabetes • Heart Failure • Hypertension • Hypotension • Metabolic Disorders • Movement Disorders • Parkinson's Disease

Adjunctive Oral Vasopressor Strategy with Midodrine and Droxidopa Bridging from Terlipressin in Refractory Hepatorenal Syndrome (NKF-SCM 2026) - "Reintroduction of terlipressin with cross-titration to midodrine and droxidopa stabilized the MAP and maintained renal recovery. CONCLUSION This case illustrates the potential role droxidopa may serve as an adjunct oral agent to support sustained HRS reversal and reduce reliance on prolonged inpatient vasoconstrictor therapy."

Acute Kidney Injury • Cardiovascular • Heart Failure • Hepatology • Hypotension • Immunology • Inflammation • Nephrology • Portal Hypertension • Renal Disease

Consensus Molecules Associated with Parkinson's Disease. (PubMed, Neurol Int) - "Drugs include L-dopa (49%), carbidopa (63%), benserazide (50%), entacapone (74%), tolcapone (56%), rasagiline (76%), selegiline (46%), pargyline (4%), ropinirole (61%), pramipexole (56%), lisuride (27%), cabergoline (16%), bromocriptine (12%), and zonisamide (9%). Adjunctive therapies include droxidopa (33%), trihexyphenidyl (28%), biperiden (17%), amantadine (24%), memantine (7%), rivastigmine (13%), donepezil (6%), galantamine (4%), domperidone (6%), clonazepam (4%), tetrabenazine (16%), mazindol (13%), quetiapine (6%), and clozapine (4%). Contraindicated drugs include haloperidol (4%), sulpiride (3%), and methyldopa (6%)...Chemical inducers of PD include 6-hydroxydopamine (40%), N-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP, 78%), tetrahydropyridine (77%), probenecid (4%), quinolinic acid (4%), 1,2,3,4-tetrahydroisoquinoline (TIQ, 16%), salsolinol (32%), rotenone (25%), and β-Methylamino-L-alanine (BMAA, 29%). Notably, our study highlights conditional essential..."

Journal • Review • CNS Disorders • Movement Disorders • Parkinson's Disease

Beyond Intravenous Vasopressors in the Intensive Care Unit: The Emerging Role of Droxidopa. (PubMed, J Cardiothorac Vasc Anesth) - No abstract available

Journal • Critical care

Oral Agents for the Treatment of Refractory Hypotension in the Acute Care Setting - A Narrative Review. (PubMed, J Pharm Pract) - "Midodrine and fludrocortisone alone or in combination with each other has shown benefits in the treatment of refractory orthostatic hypotension as has the use of droxidopa. In this review, the literature evaluating the use of these oral agents for refractory hypotension is assessed with a particular focus on acute care management."

Journal • Review • Cardiovascular • Critical care • Hypotension • Nephrology

Use of Droxidopa in Weaning Vasopressors in Persistent Hypotension (ATS 2026) - No abstract available

Hypotension

Retraction Note: Alternative use of Droxidopa for treating cervical cancer: inhibiting transferase, cell cycle signalling, and transport proteins via multitarget docking, DFT, MD simulations, and binding free energy studies. (PubMed, Med Oncol) - No abstract available

Journal • Cervical Cancer • Oncology • Solid Tumor

Phase I/II Study of NORTHERA (DROXIDOPA) for Dysautonomia in Pediatric Survivors of Menkes Disease. (clinicaltrials.gov) - P1/2 | N=6 | Recruiting | Sponsor: Stephen G. Kaler

New P1/2 trial • Pediatrics

Impact of COVID‑19 infection on subsequent prescriptions of autonomic dysfunction pharmacotherapy: a nationwide propensity‑score‑matched Cohort study in Japan. (PubMed, Ann Med) - "The primary composite outcome was the first outpatient prescription of midodrine, fludrocortisone, amezinium methylsulfate, and droxidopa. COVID-19 infection is significantly associated with increased initiation of pharmacotherapy for autonomic dysfunction, with sustained risk beyond one year. These findings highlight the to manage autonomic dysfunction among COVID-19 survivors and informing clinical care and public health planning."

Journal • Cardiovascular • Congestive Heart Failure • Heart Failure • Hypotension • Infectious Disease • Myocardial Infarction • Novel Coronavirus Disease

Evaluating the interactions of L-DOPA and droxidopa toward D3 dopamine receptor through computational study: A comparison with dopamine. (PubMed, J Mol Graph Model) - "Molecular docking was conducted to evaluate binding affinities and identify key receptor-ligand interactions, followed by molecular dynamics simulations to assess the stability and dynamic behavior of the complexes in a biological environment. MM-PBSA binding free energy calculations were used to further quantify the strength of ligand binding to D3R."

Journal • CNS Disorders • Movement Disorders • Parkinson's Disease

Droxidopa in Critical Care: A Systematic Review of an Emerging Off-Label Practice. (PubMed, Crit Care Res Pract) - "Further research is warranted. No funding was received for this review, and the review was not prospectively registered."

Journal • Review • Critical care • Hypotension

Evaluation of Inclusion of Droxidopa as a Therapeutic Option for Intravenous Vasopressor Weaning on Intensive Care Unit Length of Stay in Patients with Distributive Shock (ASHP 2025) - No abstract available

Clinical • Critical care

Administration of Midodrine, Droxidopa, or the Combination of Droxidopa and Midodrine for Discontinuing Hemodynamic-Stabilizing Pharmacotherapy: a Comparison of Oral Vasopressors in Critically Ill Patients (ASHP 2025) - No abstract available

Clinical

Administration of midodrine, droxidopa, or the combination of droxidopa and midodrine for discontinuing hemodynamic-stabilizing pharmacotherapy: a comparison of oral vasopressors in critically ill patients (ASHP 2025) - "Hosted by the Section of Clinical Specialists and Scientists"

Clinical • Critical care

Radiation-Induced Baroreflex Dysfunction: A Rare Case of Severe Orthostatic Hypotension. (PubMed, Cureus) - "Treatment with droxidopa, compression therapy, and a carefully titrated antihypertensive regimen led to improvement in orthostatic tolerance...The patient remained stable throughout the 10-month follow-up with sustained symptom improvement. This case underscores the importance of recognizing radiation as a potential cause of baroreflex failure in patients with significant polyvascular disease, expanding the spectrum of presentations to include earlier onset than historically reported."

Journal • Basal Cell Carcinoma • Cardiovascular • Hypertension • Hypotension • Non-melanoma Skin Cancer • Oncology

Refractory Hyponatremia in a Patient with Malignancy: A Role for Tolvaptan (KIDNEY WEEK 2025) - "She had decreased oral intake, fatigue, and a transient episode of unresponsiveness after taking her prescribed hydromorphone...She was given albumin and droxidopa for persistent low blood pressure and Nephrology was consulted for evaluation of persistent hyponatremia...The etiology of this patient’s hyponatremia is multifactorial including hypervolemia from hypoalbuminemia, non-osmotic ADH release from hypotension and sepsis, reduced solute intake and possible SIADH from malignancy. Tolvaptan was utilized because conventional management was challenged by contraindications."

Clinical • Cardiovascular • Fatigue • Gastroenterology • Genetic Disorders • Heart Failure • Hypotension • Infectious Disease • Nephrology • Oncology • Pancreatic Adenocarcinoma • Pancreatic Cancer • Pneumonia • Respiratory Diseases • Septic Shock

Effects of Midodrine and Droxidopa on Splanchnic Capacitance in Autonomic Failure (clinicaltrials.gov) - P1 | N=34 | Recruiting | Sponsor: Vanderbilt University Medical Center | Trial completion date: Dec 2025 ➔ Dec 2026 | Trial primary completion date: Sep 2025 ➔ Sep 2026

Trial completion date • Trial primary completion date • CNS Disorders • Hypotension • Movement Disorders • Multiple System Atrophy • Parkinson's Disease • Rare Diseases

A case of Parkinson's Disease whose Daily Levodopa/Carbidopa Intestinal Gel dose has been determined by her spouse and prevented Long-term Fluctuations (MDS Congress 2025) - "Other medications, that were droxidopa 900mg and rotigotine 13.5mg, were not changed. Patients with PD sometimes experience long-term fluctuations possibly due to temperature change, stressful situations, and bad health condition other than PD, even when medication is not changed. In this patient, careful LCIG dose change by the family member might prevent long-term fluctuations. Fig."

Clinical • CNS Disorders • Movement Disorders • Parkinson's Disease

Orthostatic Hypotension in Older Adults: A Narrative Review of Causes, Drug Impacts, and Management Strategies. (PubMed, Curr Hypertens Rev) - "Effective OH management requires a personalized, multidisciplinary approach. Fu-ture research should focus on identifying reliable diagnostic biomarkers and developing individu-alized treatment algorithms to improve patient outcomes and support healthy aging."

Journal • Cardiovascular • CNS Disorders • Hypotension • Movement Disorders • Parkinson's Disease

Repetitive syncope in a newborn leading to pacemaker implantation: Evidence for dopamine beta-hydroxylase deficiency. (PubMed, HeartRhythm Case Rep) - No abstract available

Journal • Genetic Disorders