Droxidopa

Droxidopa may cause or worsen supine hypertension (high blood pressure that occurs when lying flat on your back) that may increase the risk of cardiovascular events such as heart attack and stroke. You should raise the head of your bed when resting or sleeping and take droxidopa at least 3 hours before bedtime to reduce the risk of supine hypertension. You should have your blood pressure checked before starting treatment, anytime your dose is increased, and regularly while you are taking droxidopa.

Talk to your doctor about the risks of taking droxidopa.

Droxidopa is used to treat symptoms (dizziness, lightheadedness, or a fainting sensation [feeling that you are about to black out]) of neurogenic orthostatic hypotension (a sudden fall in blood pressure that occurs when a person assumes a standing position caused by certain nervous system conditions). Droxidopa is in a class of medications called alpha and beta-adrenergic agonists. It works by increasing the levels of norepinephrine, a natural substance in the body.

Droxidopa comes as a capsule to take by mouth. It is usually taken three times a day (morning, midday, and late afternoon). Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take droxidopa exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Swallow the capsules whole; do not split, chew, or crush them.

Your doctor will probably start you on a low dose of droxidopa and gradually increase your dose every 1 to 2 days.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking droxidopa,

• tell your doctor and pharmacist if you are allergic to droxidopa, aspirin, tartrazine (a yellow dye in some processed foods and medications), other medications, or any of the ingredients in the capsule. Ask your pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take while taking droxidopa. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have or have ever had asthma, coronary artery disease (blockage or narrowing of the blood vessels that lead to the heart), irregular heartbeat, heart failure, or heart or kidney disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking droxidopa, call your doctor.

Unless your doctor tells you otherwise, continue your normal diet.

Skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Droxidopa may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• headache
• dizziness
• nausea

Some side effects can be serious. If you experience any of these symptoms call your doctor immediately or get emergency medical treatment:

• confusion
• high fever
• muscle stiffness
• unusual movements that you cannot control
• changes in awareness, thinking, or behavior

Droxidopa may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from light, excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (https://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location — one that is up and away and out of their sight and reach. https://www.upandaway.org

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Keep all appointments with your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

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