Methyldopa and Methyldopate HCl
A to Z Drug Facts
Methyldopa and Methyldopate HCl |
(meth-ill-DOE-puh and meth-ill-DOE-pate HIGH-droe-KLOR-ide) |
Aldomet |
Tablets: 125 mg methyldopa |
Tablets: 250 mg methyldopa |
Tablets: 500 mg methyldopa |
Oral Suspension: 50 mg methyldopa/ mL |
Injection: 50 mg methyldopa HCl/ mL |
Apo-Methyldopa |
Dopamet |
Medimet |
Novo-Medopa |
Nu-Medopa |
Class: Antihypertensive, Antiadrenergic, centrally acting |
Action Causes central alpha-adrenergic stimulation, which inhibits sympathetic cardioaccelerator and vasoconstrictor centers; reduces plasma renin activity; reduces standing and supine BP.
Indications Treatment of hypertension.
Contraindications Active hepatic disease or previous hepatic disease associated with methyldopa therapy; coadministration with MAO inhibitors.
Adults: PO 250 mg bid to tid in the first 48 hr initially, then 500 mg to 2 g/day in 2 to 4 divided doses. Adjust doses at intervals of not less than 2 days until adequate response is achieved.
IV 250 to 500 mg q 6 hr prn (max, 1 g q 6 hr). Children: PO 10 mg/kg/day in 2 to 4 doses (max, 65 mg/kg/day or 3 g/day, whichever is less).
IV 20 to 40 mg/kg/day in divided doses every 6 hr (max, 65 mg/kg/day or 3 g/day, whichever is less).
Anesthetics: May require reduced doses of anesthetics. Barbiturates: Actions of methyldopa may be reduced. Beta blockers: May cause paradoxical hypertension (rare). Ferrous sulfate or gluconate May decrease methyldopa absorption. Haloperidol: May result in dementia or sedation. Levodopa: BP lowering effects of methyldopa may be potentiated. Central effects of levodopa in Parkinson disease may be potentiated. Lithium: May precipitate lithium toxicity. MAO inhibitors: May lead to excessive sympathetic stimulation. Phenothiazines: Serious elevations in BP may occur. Sympathomimetics: May potentiate pressor effects of sympathomimetics and lead to hypertension. Tolbutamide: Enhanced hypoglycemic effects may occur. Tricyclic antidepressants: Reversal or attenuation of the hypotensive effects of methyldopa.
Lab Test Interferences May interfere with tests for urinary uric acid, serum creatinine, AST; may give falsely high levels of urinary catecholamines, abnormal LFT results, positive Coombs' test, or rise in BUN.
CARDIOVASCULAR: Bradycardia; prolonged carotid sinus hyperactivity; aggravation of angina pectoris; CHF; paradoxical pressor response with IV use; pericarditis; myocarditis; orthostatic hypotension; edema. CNS: Dizziness; sedation; nightmares; headache; asthenia or weakness; paresthesias; lightheadedness; symptoms of cerebrovascular insufficiency; parkinsonism; Bell's palsy; decreased mental acuity; involuntary choreoathetotic movements. DERMATOLOGIC: Rash; toxic epidermal necrolysis. EENT: Sore or black tongue; nasal stuffiness. GI: Constipation; dry mouth; nausea; vomiting; distention; flatus; diarrhea; sialadentis. GU: Impotence; decreased libido; rise in BUN. HEPATIC: Abnormal LFTs; jaundice; hepatitis or liver disorders. HEMATOLOGIC: Hemolytic anemia; bone marrow depression; leukopenia; granulocytopenia; thrombocytopenia; reduced WBC count; positive tests for anti-nuclear antibody, lupus erythematosus cells and rheumatoid factor. METABOLIC: Breast enlargement; gynecomastia; lactation; amenorrhea. OTHER: Fever; lupus-like syndrome; mild arthralgia or myalgia.
Pregnancy: Category B (methyldopa); Category C (methyldopate HCl). Lactation: Excreted in breast milk. Children: Individualize dosage. Elderly: Syncope in older patients may be related to an increased sensitivity and advanced arteriosclerotic vascular disease. May be avoided by lower doses. Hepatic/Renal function impairment: Use with caution in patients with hepatic or renal dysfunction. IV use: Paradoxical pressor response has been reported. Liver disorders: Jaundice, with or without fever, may occur. Fatal hepatic necrosis has been reported rarely. If symptoms or tests indicate liver effects, the drugs may need to be discontinued. Positive Coombs' test, hemolytic anemia, and liver disorders: May occur; monitor patient closely because of potentially fatal complications. Blood transfusions: Perform both a direct and an indirect Coomb's test. A positive direct Coomb's test alone will not interfere with typing or cross matching. If the indirect Coomb's test is also positive, problems may arise in the major cross-match and assistance from a hematologist or transfusion expert will be needed.
PATIENT CARE CONSIDERATIONS |
Methyldopa
Methyldopate HCl
|
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Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts