droxidopa / Generic mfg. - LARVOL DELTA

TARGETING NEUROGENIC VASOPLEGIA: DROXIDOPA AS RESCUE THERAPY FOR REFRACTORY INTRADIALYTIC HYPOTENSION IN A PATIENT WITH ANEPHRIC ESRD AND ADRENAL INSUFFICIENCY (CHEST 2026) - No abstract available

Clinical • Endocrine Disorders • Hypotension • Nephrology • Renal Disease

REFRACTORY INTRADIALYTIC HYPOTENSION IN SEVERE PULMONARY HYPERTENSION: HEMODYNAMIC RESCUE WITH DROXIDOPA (CHEST 2026) - No abstract available

Cardiovascular • Hypotension • Pulmonary Arterial Hypertension • Pulmonary Disease • Respiratory Diseases

Hypertensive emergency with vasogenic cerebral edema following droxidopa initiation in pure autonomic failure. (PubMed, Front Neurol) - "We report a 60-year-old woman with advanced PAF who developed a hypertensive emergency with vasogenic cerebral edema shortly after initiation of low-dose droxidopa. This case highlights that severe hypertensive complications with reversible cerebral edema may occur even during low-dose droxidopa initiation in vulnerable patients with advanced autonomic dysfunction, underscoring the need for cautious dose titration and close BP monitoring."

Journal • Hypotension

Recurrent Syncope Due to Orthostatic Hypotension Following Lateral Medullary Infarction: A Case Report. (PubMed, Intern Med) - "Sequential treatment with midodrine, fludrocortisone, and droxidopa resolved the symptoms. Serial head-up tilt testing suggested a partial improvement in the orthostatic hemodynamic responses. Orthostatic hypotension should be considered in patients with lateral medullary infarction and positional symptoms, and serial head-up tilt testing may help document any changes in the orthostatic hemodynamic response."

Journal • Ataxia • Cardiovascular • Hypotension • Movement Disorders

Enantio- and diastereopure production of n-amino-4-hydroxycycloalkanecarboxylic acids | Poster Board #1760 (ACS-Fall 2026) - "The hydroxy amino acid motif is common in nature and in medicinal chemistry, from the canonical amino acid serine to complex natural products like hapalosin, to synthetic drugs such as atorvastatin and droxidopa. The key step of the synthetic sequence is diastereoselective halocyclization (1a → 2a; 8 → 9) to construct cyclic frameworks with high stereocontrol, followed by selective transformations (hydrolysis, reduction, and deprotection) that preserve stereochemical integrity (conformationally limited GABA analogs 5a and 5b were isolated with 99% ee optical purity). This approach provides a highly stereoselective route to hydroxy amino acids and access to bicyclic carbamate intermediates as versatile synthons."

DROP-AKI: Droxidopa to Increase Mean Arterial Pressure in Decompensated Cirrhosis Patients With Acute Kidney Injury (clinicaltrials.gov) - P2 | N=75 | Recruiting | Sponsor: Giuseppe Cullaro, MD | Trial completion date: Dec 2027 ➔ Dec 2028 | Trial primary completion date: Dec 2026 ➔ Dec 2027

Trial completion date • Trial primary completion date • Acute Kidney Injury • Fibrosis • Immunology • Liver Cirrhosis • Nephrology • Renal Disease

Treatment of Orthostatic Hypotension in SCI (clinicaltrials.gov) - P4 | N=25 | Recruiting | Sponsor: James J. Peters Veterans Affairs Medical Center | Trial completion date: Jun 2026 ➔ Jun 2027 | Trial primary completion date: Jun 2026 ➔ Jun 2027

Trial completion date • Trial primary completion date • CNS Disorders • Hypotension • Orthopedics

Droxidopa / Pyridostigmine in Orthostatic Hypotension (clinicaltrials.gov) - P2 | N=30 | Enrolling by invitation | Sponsor: Mayo Clinic | Trial completion date: May 2026 ➔ May 2027 | Trial primary completion date: May 2026 ➔ May 2027

Trial completion date • Trial primary completion date • Cardiovascular • Hypertension • Hypotension

Novel Use of Droxidopa for Refractory Orthostatic Hypotension in Peritoneal Dialysis with Excellent Clinical Outcomes (ERA 2026) - "Midodrine was ineffective and poorly tolerated due to urinary side effects. Fludrocortisone caused recurrent hypokalaemia requiring hospitalisation, and pyridostigmine was discontinued due to cholinergic adverse effects...This case supports further evaluation of droxidopa in PD patients with refractory orthostatic hypotension. Image"

Clinical • Clinical data • Chronic Kidney Disease • CNS Disorders • Diabetes • Diabetic Nephropathy • Diabetic Neuropathy • Endocrine Cancer • Endocrine Disorders • Hypotension • Metabolic Disorders • Nephrology • Renal Disease • Type 2 Diabetes Mellitus

Exploring the Link Between Pharmacological Management of Orthostatic Hypotension and Cognitive Performance: A Scoping Review. (PubMed, Drugs Aging) - "Limited conclusions can be drawn from these five studies because of non-standardized cognitive assessments, small sample sizes, and methodological variability. However, overall, this scoping review provides evidence that treatment of orthostatic hypotension might have a cognitive benefit in certain populations. Further observational studies and clinical trials are warranted to better elucidate whether combinations of midodrine, droxidopa, and fludrocortisone will work in specific patient populations to improve clinical outcomes."

Journal • Review • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Dementia • Hypotension • Movement Disorders • Orthopedics • 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

Safety and efficacy of droxidopa for dysautonomia in adults with Menkes disease and occipital horn syndrome in the USA: a randomised phase 1/2a crossover trial. (PubMed, EClinicalMedicine) - P1/2 | "Further research is required, including in younger individuals with these conditions. The Menkes Disease Foundation UK, Associazione Angeli Per La Vita, and the Abigail Wexner Research Institute at Nationwide Children's Hospital."

Journal • P1/2 data • Hypotension • ATP7A

Management of Orthostatic Hypotension: A Review. (PubMed, JAMA Intern Med) - "Midodrine and droxidopa are the only US Food and Drug Administration-approved medications for orthostatic hypotension, but other medications (eg, fludrocortisone, atomoxetine, pyridostigmine) are used off label as part of an individualized treatment plan. All patients with orthostatic symptoms-along with other select patient groups-should be evaluated for orthostatic hypotension. Nonpharmacological treatments are first line, and medication decisions should be tailored based on clinical presentation and relevant comorbidities."

Journal • Cardiovascular • CNS Disorders • Hypertension • Hypotension

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

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