Formulary
Methyldopa: Indications, Dosing, Side Effects and Interactions
Methyldopa clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Methyldopa: Indications, Dosing, Side Effects and Interactions
Methyldopa clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Hypertension**
- **Adult** (By Mouth): 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** (By Mouth): Initially 125 mg twice daily, dose should be increased gradually; maximum 2 g per day.
Cautions
History of hepatic impairment Cautions, further information Elderly For centrally-acting antihypertensives, Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria to aid medication reviews (see Prescribing in the elderly for information): potentially inappropriate unless clear intolerance of, or lack of efficacy with, other classes of antihypertensives (generally less well tolerated by older people).
Contraindications
Acute porphyrias ; depression; paraganglioma; phaeochromocytoma
Side effects
Frequency not known Abdominal distension; amenorrhoea; angina pectoris; angioedema; arthralgia; asthenia; atrioventricular block; bone marrow failure; bradycardia; breast enlargement; cardiac inflammation; carotid sinus syndrome; cerebrovascular insufficiency; choreoathetosis; cognitive impairment; constipation; depression; diarrhoea; dizziness; dry mouth; eosinophilia; facial paralysis; fever; gastrointestinal disorders; granulocytopenia; gynaecomastia; haemolytic anaemia; headache; hepatic disorders; hyperprolactinaemia; lactation disorder; leucopenia; lupus-like syndrome; myalgia; nasal congestion; nausea; nightmare; oedema; pancreatitis; paraesthesia; parkinsonism; postural hypotension; psychiatric disorder; psychosis; sedation; sexual dysfunction; sialadenitis; skin reactions; thrombocytopenia; tongue burning; tongue discolouration; toxic epidermal necrolysis; vomiting Side-effects, further information Side-effects are minimised if the daily dose is kept below 1g; discontinue permanently if fever or hepatic disorders occur.
Interactions
**Other interactions (13):**
- Alcohol concomitant use may enhance the hypotensive effect.
- Alprostadil concomitant use may enhance the hypotensive effect.
- Beta-blockers Concomitant use may enhance the hypotensive effect.
- Corticosteroids Concomitant use may antagonise the hypotensive effect.
- Diuretics Concomitant use may enhance the hypotensive effect.
- Concomitant use with levodopa or entacapone may enhance the hypotensive effect.
Pregnancy
Not known to be harmful.
Breast feeding
Amount too small to be harmful.
Hepatic impairment
Manufacturer advises avoid in active disease.
Renal impairment
Dose adjustments May respond to lower doses (increased sensitivity to hypotensive and sedative effect). M
Medicinal forms
Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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