Methyldopa

May be taken with or without food.

Active liver disease (e.g. acute hepatitis, active cirrhosis), liver disorders associated with previous use of methyldopa, catecholamine-secreting tumour (e.g. phaeochromocytoma, paraganglioma), porphyria, depression. Concurrent administration of MAOIs (e.g. phenelzine).

Patients with severe bilateral cerebrovascular disease. Patients undergoing surgery. Renal or history of hepatic impairment. Children and elderly. Pregnancy and lactation. Patient Counselling This drug may cause drowsiness, if affected, do not drive or operate machinery. Monitoring Parameters Monitor blood pressure (standing and sitting/lying down), CBC, liver enzymes (periodically during the 1st 6-12 weeks or when unexplained fever occurs). Direct Coombs test before initiation of therapy and at 6 and 12 months is recommended.

Significant: Oedema, weight gain, reversible granulocytopenia and thrombocytopenia, sedation, fever, jaundice, depression. Blood and lymphatic system disorders: Bone marrow depression, leucopenia, eosinophilia. Cardiac disorders: Bradycardia, angina pectoris, myocarditis, pericarditis, atrioventricular block. Endocrine disorders: Hyperprolactinaemia. Gastrointestinal disorders: Nausea, vomiting, abdominal distension, constipation, flatulence, diarrhoea, colitis, xerostomia, glossodynia, melanoglossia, sialoadenitis, pancreatitis. General disorders and administration site conditions: Asthenia. Hepatobiliary disorders: Hepatitis. Immune system disorders: Lupus-like syndrome. Investigations: Positive Coombs test, positive tests for antinuclear antibody, LE cells, and rheumatoid factor, abnormal LFT, increased BUN. Musculoskeletal and connective tissue disorders: Mild arthralgia, myalgia. Nervous system disorders: Bell's palsy, headache, paraesthesia, parkinsonism, choreoathetosis, carotid sinus syndrome, dizziness, symptoms of cerebrovascular insufficiency. Psychiatric disorders: Nightmares, impaired mental acuity, reversible mild psychosis. Reproductive system and breast disorders: Breast hypertrophy, gynaecomastia, amenorrhoea, lactation, decreased libido, erectile dysfunction, ejaculation failure. Respiratory, thoracic and mediastinal disorders: Nasal congestion. Skin and subcutaneous tissue disorders: Rash (i.e. eczema, lichenoid eruption), urticaria, toxic epidermal necrolysis. Vascular disorders: Orthostatic hypotension.
Potentially Fatal: Hepatic necrosis, haemolytic anaemia.

May increase lithium toxicity. May potentiate the effect of other antihypertensive drugs (e.g. atenolol). Sympathomimetics (e.g. phenylephrine), phenothiazines (e.g. chlorpromazine), and TCAs (e.g. amitriptyline) may diminish the antihypertensive effect of methyldopa. Iron preparations (e.g. ferrous sulfate) may decrease the serum concentration of methyldopa.

Other Antihypertensives

C02AB - Methyldopa ; Used in the treatment of hypertension.