Which medications in the drug class Alpha/Beta Adrenergic Agonists are used in the treatment of Multiple System Atrophy?

Updated: Oct 17, 2018
  • Author: André Diedrich, MD, PhD; Chief Editor: Selim R Benbadis, MD  more...
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Alpha/Beta Adrenergic Agonists

These agents augment coronary and cerebral blood flow. Agents such as ephedrine have been used in patients with MSA and share with midodrine the possible complication of excessive supine hypertension. The advantage of these short-acting vasopressors is that they can be given during the day if the patient does not lie down for 3-4 hours after taking them. A late-afternoon dose should be avoided if possible.

Droxidopa (Northera)

Droxidopa is an oral norepinephrine precursor that is directly metabolized to norepinephrine by dopa-decarboxylase which is extensively distributed throughout the body. Peak droxidopa plasma concentrations are associated with increases in systolic and diastolic blood pressures. Droxidopa has no clinically significant effect on standing or supine heart rates in patients with autonomic failure. It is indicated for symptomatic neurogenic orthostatic hypotension (NOH) in patients with primary autonomic failure caused by diseases and conditions (eg, Parkinson disease, multiple system atrophy, and pure autonomic failure, dopamine beta-hydroxylase deficiency, and nondiabetic autonomic neuropathy).


Ephedrine is a sympathomimetic amine. It is an alpha- and a beta-adrenergic agonist and a peripheral vasoconstrictor.

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