As the country begins to emerge from the stay-at-home restrictions resulting from COVID-19, people are anxious to get back to life before lockdown. Even with some restrictions still in place, it’s important for physical and emotional health to get outside and take in the fresh air. Now, with the summer months upon us, the ability to enjoy the warmer weather is a reality.
For some, however, the heat and humidity doesn’t always mean fun in the sun. Instead, it may affect their health by causing uncomfortable and dangerous symptoms. Those living with neurodegenerative conditions, such as Parkinson’s disease (PD), need to be especially careful not to assume that those negative symptoms are a result of the weather.
“Being in a hot environment can lead to dehydration, which can contribute to lowering your blood pressure,” says Jerome Lisk MD, FAAN, Neurologist and Movement Disorder Specialist. “The lowering of blood pressure can trigger acute orthostatic hypotension (OH) in some people, which means your blood pressure significantly falls within seconds or minutes of standing.”
Dr. Lisk goes on to say, “Experiencing this drop in blood pressure can lead to symptoms like lightheadedness, blurred vision, dizziness, or a general feeling of weakness.”
While some people may experience these symptoms as the temperature gets warmer, people living with PD and other neurodegenerative conditions should be careful not to misinterpret the symptoms of feeling dizzy or lightheaded as weather related. These symptoms could potentially be an underlying condition called neurogenic orthostatic hypotension, or nOH. Dr. Lisk says, “nOH is a subset of OH and is a condition that is associated with several neurodegenerative diseases, like PD, multiple system atrophy (MSA) and pure autonomic failure (PAF). Hot, humid environments can exacerbate symptoms of nOH and may lead patients to assume the heat is the cause of their symptoms, when in fact, it could be nOH caused by their underlining neurological disorder.”
Symptomatic nOH is due in large part to the fact that the body does not release enough norepinephrine upon standing. As a result, blood vessels are unable to tighten as they should, preventing the blood from being pumped back up to the head and upper torso resulting in lightheadedness, dizziness or the feeling of blacking out, among other common symptoms. The good news is that symptomatic nOH can be both diagnosed and managed. While there are non-pharmacological interventions to manage nOH – like drinking two glasses of water within 2-3 minutes of experiencing symptoms, increasing your salt intake, wearing abdominal binders, etc. – there is also a treatment option available.
NORTHERA® (droxidopa) is a prescription medication that has been shown to improve symptoms of dizziness, lightheadedness and the feeling of blacking out by week one. It is the only FDA-approved treatment specifically studied in patients with symptomatic nOH. While NORTHERA® might not be right for everyone, patients with a neurodegenerative condition can help their doctor determine if it could be the right fit for them by answering a quick online survey at NORTHERA.com and bringing their results to their physician.
Although there is no cure for symptomatic nOH, NORTHERA® may help to reduce the symptoms. People can learn more about symptomatic nOH, hear from other patients, or download helpful resources by going to NORTHERA.com.
USE OF NORTHERA (droxidopa) CAPSULES (100 mg, 200 mg, 300 mg)
NORTHERA (droxidopa) is a prescription medication used to reduce dizziness, lightheadedness, or the “feeling that you are about to black out” in adults who experience a significant drop in blood pressure when changing positions or standing (called symptomatic neurogenic orthostatic hypotension (nOH)) and who have one of the following:
- Parkinson’s disease (PD), a neurodegenerative disease that causes slowness in muscle movement as well as shaking in the hands
- Multiple system atrophy (MSA), a Parkinson’s-like disorder with more widespread effects on the brain and body
- Pure autonomic failure (PAF), a neurodegenerative disease that results in frequent drops in blood pressure upon standing
- Dopamine beta-hydroxylase deficiency, a condition where the body cannot make enough of the hormones that help regulate blood pressure
- Non-diabetic autonomic neuropathy, an inability to maintain blood pressure upon standing that can be caused by a number of rare diseases
Effectiveness beyond 2 weeks of treatment has not been established, and your doctor will decide if you should continue taking NORTHERA.
IMPORTANT SAFETY INFORMATION
- Do not take NORTHERA if you have a known allergy to NORTHERA or its ingredients.
- NORTHERA may cause high blood pressure when lying down, which could lead to strokes, heart attacks, and death. To reduce this risk of supine hypertension, take your late afternoon dose of NORTHERA at least 3 hours before going to bed.
- Neuroleptic malignant syndrome (NMS) is a rare but potentially life-threatening side effect reported with NORTHERA. Call your doctor right away and go to the nearest emergency room if you develop these signs and symptoms: high fever, stiff muscles, movements that you cannot control, confusion or problems thinking, very fast or uneven heartbeats, or increased sweating. NORTHERA should be stopped immediately if NMS is diagnosed.
- If you have coronary artery disease, irregular heartbeat, or heart failure, NORTHERA may worsen the symptoms of these disorders. Call your doctor if your symptoms become worse.
- NORTHERA may cause allergic reactions. Stop taking NORTHERA and contact your doctor right away, or go to the nearest emergency room if you experience any signs or symptoms of an allergic reaction such as: fast heartbeat, nausea, vomiting, swelling, trouble breathing, hives, or rash. NORTHERA contains tartrazine (FD&C Yellow No. 5), which may also cause an allergic reaction, especially if you have had a reaction to aspirin.
- The most common side effects with NORTHERA are headache, dizziness, nausea, and high blood pressure.
- Taking NORTHERA with other medications may cause side effects. Tell your doctor if you take prescription or over-the-counter medicines, vitamins, or herbal supplements.
- You should not breastfeed during treatment with NORTHERA.
- If you plan to become or are currently pregnant, talk to your doctor as it is not known if NORTHERA could harm your unborn baby.
- Take NORTHERA the same way each time, either with or without food.
- If you miss a dose of NORTHERA, take your next dose at the regularly scheduled time. Do not double the dose.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
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