Drug interactions
Droxidopa + Pseudoephedrine
Severity: Major
Droxidopa and Pseudoephedrine: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both drugs increase noradrenergic activity, so together they can cause excessive blood pressure elevation, including supine hypertension. This is clinically important because droxidopa is used in patients with neurogenic orthostatic hypotension who already risk supine hypertension.
What this interaction means in plain words
Droxidopa and Pseudoephedrine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Droxidopa belongs to Cardiovascular; Pseudoephedrine belongs to Respiratory.
Why it happens
Additive pressor effects: droxidopa is converted to norepinephrine while pseudoephedrine releases norepinephrine.
What to do
Avoid the combination if possible; if used, monitor supine and standing blood pressure and keep the head of the bed elevated. Reduce or stop one agent if blood pressure rises excessively.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Pseudoephedrine
- Isocarboxazid + Pseudoephedrine Contraindicated
- Phenelzine + Pseudoephedrine Contraindicated
- Pseudoephedrine + Rasagiline Contraindicated
- Pseudoephedrine + Selegiline Contraindicated
- Pseudoephedrine + Selegiline transdermal Contraindicated
- Pseudoephedrine + Tranylcypromine Contraindicated
Other interactions of Droxidopa
- Droxidopa + Lisdexamfetamine Major
- Droxidopa + Methamphetamine Major
- Adrenaline-articaine + Droxidopa Moderate
- Almotriptan + Droxidopa Moderate
- Caffeine + Droxidopa Moderate
- Carbidopa-entacapone-levodopa + Droxidopa Moderate
Frequently asked questions
Can I take Droxidopa with Pseudoephedrine?
MediHelp rates the interaction as major. Droxidopa and Pseudoephedrine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both drugs increase noradrenergic activity, so together they can cause excessive blood pressure elevation, including supine hypertension. This is clinically important because droxidopa is used in patients with neurogenic orthostatic hypotension who already risk supine hypertension.
How serious is the interaction between Droxidopa and Pseudoephedrine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination if possible; if used, monitor supine and standing blood pressure and keep the head of the bed elevated. Reduce or stop one agent if blood pressure rises excessively.
What other medicines interact with Pseudoephedrine?
MediHelp also lists interactions of Pseudoephedrine with, for example, Isocarboxazid, Phenelzine, Rasagiline. The full list is on the Pseudoephedrine page.
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