| drug details | | name | Methyldopa | | classification | Antihypertensive agent, centrally acting adrenergic inhibitor | | pharmacokinetics | Methyldopa is rapidly absorbed from the gastrointestinal tract. Peak plasma levels are reached within 1-2 hours. Significant first-pass metabolism occurs. It is metabolized to its active form, methylnorepinephrine, in the CNS. Methyldopa is extensively metabolized in the liver, with the primary route of excretion being the urine. Elimination half-life varies, but is typically around 2 hours. | | suggested dosage | | adult | | initial | 250 mg to 500 mg orally 2-3 times daily, adjusted to a maintenance dosage of 500mg to 2g daily in divided doses. | | pediatric | | dosage information | Dosage should be individualized based on age, weight, and response to therapy. |
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| | weight specific note | Dosage should be carefully adjusted, taking into consideration age, renal function, and other factors. A starting dose of 250mg can be considered and titrated in increments as needed. |
| | indications | Essential hypertension, especially in patients for whom other antihypertensives are poorly tolerated or ineffective. Can be considered in pregnancy, however, it is best to follow current guidelines from reputable medical sources. Should be used with caution in situations with active or suspected neurological dysfunction, peripheral vascular disease, or heart failure, particularly if it is decompensated. | | safety in pregnancy | Generally considered safe for use during pregnancy, but it's important to note that the drug does cross the placenta and its effects on the fetus are not fully understood. A pregnant patient should consult with her doctor carefully before using methyldopa. | | safety in breastfeeding | Methyldopa can be excreted in breast milk, therefore, women who are breastfeeding should carefully consider the risks and benefits of using this medication. A consultation with a physician is essential. | | side effects | | 1 | Drowsiness, dizziness, orthostatic hypotension (especially during initiation of therapy), headache, nausea, vomiting, abdominal pain, dry mouth, liver enzyme abnormalities, hematological effects like anemia and thrombocytopenia, rash, and rarely, drug-induced lupus syndrome, hepatitis, and pancreatitis. |
| | alternatives | | | contraindications | | 1 | Known hypersensitivity to methyldopa or other components of the formulation. Active hepatic disease, and active/suspected neurological dysfunction, peripheral vascular disease, and heart failure, should be carefully considered before prescribing. |
| | interactions | Methyldopa may interact with other medications, including MAO inhibitors, antidepressants, anticonvulsants, other antihypertensives, and certain psychotropic medications. Be sure to disclose all medications to your healthcare professional. | | warnings and precautions | Monitor blood pressure frequently, especially during initiation of therapy. Monitor for signs of liver dysfunction. Monitor complete blood count periodically. Avoid abruptly discontinuing the medication. Caution should be used in patients with pre-existing liver disease, kidney disease, or a history of lupus or autoimmune conditions. Be especially vigilant in older adults and those with severe cardiovascular conditions. Inform your patient to report any unusual or concerning side effects, especially if they occur suddenly or are unusual for them. | | additional information | Methyldopa can cause positive Coombs' test results, which might be misinterpreted as a sign of another disease. It is important to inform the laboratory that the patient is taking methyldopa if such testing is to be performed. Follow-up appointments and laboratory testing may be needed to closely monitor the patient. | | patient specific details | | age | 25 years | | weight | 70 kg | | note | These details are provided as general information and should not be considered medical advice. Always consult with a qualified healthcare professional for appropriate diagnosis, treatment, and management of any medical condition. |
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