METHYLDOPA

Indications & Dose:

Hypertension

• BY MOUTH

Adult: Initially 250 mg 2–3 times a day, dose should be increased gradually at intervals of at least 2 days; maximum 3 g per day Elderly: Initially 125 mg twice daily, dose should be increased gradually; maximum 2 g per day

Children: 10mg/kg/day in 2-4 doses, adjust according to response,max; 65mg/kg or 3g daily which ever is less

Contraindications:

Active hepatic disease

Side Effects:

CNS: Asthenia, Bell’s palsy, decreased mental acuity, depression, dizziness, headache, involuntary choreoathetotic movements, light-headedness, paresthesias, parkinsonism, psychic disturbances, sedation, symptoms of cerebrovascular insufficiency

CV: Aggravation of angina pectoris, bradycardia, edema, myocarditis, orthostatic hypotension, paradoxical pressor response, pericarditis, prolonged carotid sinus hypersensitivity

EENT: Dry mouth, nasal stuffiness

GI: Abnormal liver function tests, colitis, constipation, diarrhea, distension, flatus, hepatitis, jaundice, nausea, pancreatitis, sialoadenitis, vomiting

GU: Decreased libido, failure to ejaculate, impotence

HEME: Bone marrow depression, eosinophilia, granulocytopenia, hemolytic anemia, positive Combs test (10-20% ), positive tests for antinuclear antibody. LE cells, and rheumatoid factor

METAB: Amenorrhea breast enlargement, galactorrhea, hypoproteinemia

MS: Arthralgia, myalgia

SKIN: Rash, toxic epidermal necrolysis

MISC: Fever, lupus-like syndrome

Cautions:

Precautions:

History of liver disease, pheochromocytoma, sulfite sensitivity, renal failure, autonomic dysfunction.

Pregnancy, breast-feeding old age: May be used with caution.

Interaction:

Drugs 

ß-blockers: Rebound hypertension from methyldopa withdrawal exacerbated by noncardioselective ß-blockers

Iron: Inhibited antihypertensive response to methyldopa

Lithium: Lithium toxicity not necessarily associated with excessive lithium concentrations

Tricyclic antidepressants: Inhibit the antihypertensive response

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: