Parkinson Disease and Orthostatic Hypotension in the Elderly: Recognition and Management of Risk Factors for Falls

LeWitt Peter A, Kymes Steve, Hauser Robert A

Table 5 Pharmacologic Treatments for nOH/OH.

Medication Level of Evidence [99] Comments Droxidopa [26,91] A •FDA approved for symptomatic nOH Midodrine [37,90] A •FDA approved for symptomatic OH Fludrocortisone [37] C •First-line monotherapy for OH •Full benefit requires high dietary salt and adequate fluid intake Octreotide [37] C •May be used 30 minutes before a meal to reduce postprandial OH Pyridostigmine [26] C •For patients with less severe symptoms with residual sympathetic function Ephedrine [37] N/A •Considered GPP but no clear evidence for use in OH Yohimbine [37] N/A •Considered GPP but no clear evidence for use in OH •Has been used in refractory OH Dihydroergotamine [37] N/A •Considered GPP but no clear evidence for use in OH •Has been used in severe OH Desmopressin [37] N/A •Considered GPP but no clear evidence for use in OH Erythropoietin [37] N/A •Considered GPP but no clear evidence for use in OH •Recommended in anemic patients Indomethacin [37] N/A •Considered GPP but no clear evidence for use in OH •Has been used in severe OH