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This medication comes with important safety information that you should consider before starting treatment. Please review the following points and discuss any concerns with your healthcare provider:

• Increased Blood Pressure While Lying Down: This medication can cause a significant rise in blood pressure when you are lying flat. To minimize this risk, avoid taking the medication while lying down. Elevating the head of your bed can help manage this risk, but if high blood pressure persists, your doctor may need to adjust or discontinue the medication. Uncontrolled supine hypertension can lead to serious complications such as stroke or heart attack.

• Neuroleptic Malignant Syndrome-Like Symptoms: Rarely, this medication may cause symptoms resembling neuroleptic malignant syndrome (NMS), such as high fever, muscle stiffness, uncontrollable movements, and confusion. It is crucial to monitor for these symptoms, particularly when your dosage changes, and seek immediate medical attention if they occur.

• Exacerbation of Heart Conditions: Droxidopa (Northera) may aggravate existing heart conditions, including heart disease, heart failure, and arrhythmias. Inform your healthcare team about any heart issues you have before beginning treatment to assess your risk.

• Severe Allergic Reactions: There is a possibility of experiencing a severe allergic reaction to this medication, including anaphylaxis, which can be life-threatening. Some formulations contain Yellow No. 5 (tartrazine), which may cause breathing difficulties in sensitive individuals. Seek urgent medical attention if you develop a rash, difficulty breathing, or swelling of the face, tongue, or throat.

Always consult with your healthcare provider to ensure this medication is safe for you, particularly if you have any pre-existing conditions or are taking other medications. In case of an overdose or severe side effects, seek immediate medical assistance.

When taking Northera (droxidopa), it's important to be aware of potential interactions with other medications:

• Medications That Raise Blood Pressure: Combining Northera with drugs that also increase blood pressure, such as norepinephrine, ephedrine, Midodrine, or triptans (commonly used for migraines), can heighten the risk of supine hypertension—a condition where blood pressure rises significantly when lying down. This can lead to serious cardiovascular events if not properly managed.

• Parkinson's Disease Treatments: If you're using dopa-decarboxylase inhibitors, which are often prescribed for Parkinson's disease, adjustments to your Northera dosage may be necessary to ensure safety and effectiveness.

• Monoamine Oxidase (MAO) Inhibitors: While selective MAO-B inhibitors like Rasagiline or Selegiline were allowed during Northera clinical trials, it's advisable to avoid non-selective MAO inhibitors and Linezolid. These combinations can potentially cause dangerous increases in blood pressure.

Always inform your healthcare provider about all medications and supplements you're currently taking. This will help them assess potential interactions and adjust your treatment plan accordingly to ensure your safety.