For the management of orthostatic hypotension, two primary medications are commonly used: Midodrine and Droxidopa. These drugs help to increase blood pressure when a person stands up, alleviating symptoms associated with a sudden drop in blood pressure.
Orthostatic hypotension is a condition characterized by a significant drop in blood pressure that occurs when a person stands up from a sitting or lying position, often leading to dizziness, lightheadedness, or fainting.
Pharmacologic Management Options
When non-pharmacologic measures are insufficient, specific medications can be prescribed to manage orthostatic hypotension. The choice of drug depends on various factors, including the patient's specific symptoms, underlying conditions, and response to treatment.
Here are the commonly prescribed drugs and their typical dosages:
| Drug | Dosage |
|---|---|
| Midodrine | Start at 2.5 mg three times per day orally, and titrate up to 10 mg three times per day |
| Droxidopa (Northera) | Start at 100 mg three times per day orally, and titrate up to 600 mg three times per day |
Midodrine
Midodrine is an alpha-1 adrenergic agonist that causes vasoconstriction, thereby increasing blood pressure. It is typically taken during waking hours to avoid supine hypertension (high blood pressure while lying down).
Droxidopa
Droxidopa is a prodrug that is converted to norepinephrine, a neurotransmitter that helps regulate blood pressure. It is particularly useful for patients with neurogenic orthostatic hypotension, where the body's natural production of norepinephrine might be impaired.
For further detailed information on the pharmacologic management of orthostatic hypotension, reputable medical resources such as the American Academy of Family Physicians (AAFP) provide comprehensive guidance.
