Drug*	Dosage	Comments	Cost†
Midodrine	Start at 2.5 mg three times per day orally, and titrate up to 10 mg three times per day	Dosage of 10 mg three times per day improves standing blood pressure measurements and symptom scores during a six-week course56–58 Avoid three to five hours before bedtime22,24	10 mg: $33 (—) for 60 tablets
Droxidopa (Northera)	Start at 100 mg three times per day orally, and titrate up to 600 mg three times per day	Improvement in symptom score based on validated assessment tool with medication titrated to symptom and blood pressure response over 14 days (mean dose = 430 mg)60 Avoid five hours before bedtime24 Effects may be blunted if coadministered with carbidopa22	Only available at specialty pharmacies
Fludrocortisone	Start at 0.1 mg once per day orally, and titrate up to 0.2 mg once per day	Improvement in symptoms based on validated assessment over three-week treatment period with 0.1 mg once per day orally62 Use caution in heart failure Potassium level should be monitored 2,22,24	0.1 mg: $13 (—) for 30 tablets
Atomoxetine (Strattera)	18 mg once per day orally	Improvement in standing blood pressure and validated symptom scores2,64,65	18 mg: $27 ($392) for 30 tablets
Pyridostigmine (Mestinon)	60 mg once per day orally	Improved postural diastolic blood pressure reduction with 60-mg dosage63	60 mg: $9 ($508)for 30 tablets