Drug Interactions between AirDuo Respiclick and droxidopa

MONITOR: Agents that increase blood pressure such as vasopressors, triptans, decongestants, beta-2 agonists, and amphetamines may potentiate the risk of supine hypertension associated with the use of droxidopa in the treatment of neurogenic orthostatic hypotension.

MANAGEMENT: Supine blood pressure should be monitored prior to and during droxidopa treatment, and more frequently when increasing dosage. Patients should elevate the head of the bed when resting or sleeping, and have blood pressure also measured in this position. Dosage reduction or discontinuation of droxidopa is recommended if supine hypertension cannot be managed by elevation of the head of the bed. Supine hypertension that is not well managed may increase the risk of cardiovascular events, particularly stroke.

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Although they are often combined in clinical practice, the concomitant use of beta-2 adrenergic agonists and corticosteroids may result in additive hypokalemic effects. Since beta-2 agonists can sometimes cause QT interval prolongation, the development of hypokalemia may potentiate the risk of ventricular arrhythmias including torsade de pointes. However, clinical data are limited, and the potential significance is unknown. Patients who are receiving systemic or nebulized formulations of beta-2 agonists, high dosages of inhaled beta-2 agonists, or systemic corticosteroid therapy may be at a greater risk of developing hypokalemia.

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