Drug reference
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
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Acute porphyrias p. 1120. depression. paraganglioma. phaeochromocytoma
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History of hepatic impairment CAUTIONS, FURTHER INFORMATION ▶Elderly For centrally-acting antihypertensives, prescription potentially inappropriate (STOPP criteria), unless clear intolerance of, or lack of efficacy with, other classes of antihypertensives (generally less well tolerated by older people). See also Prescribing in the elderly p. 33.
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→Appendix 1: methyldopa
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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.
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Not known to be harmful.
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Amount too small to be harmful.
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Manufacturer advises avoid in active disease.
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Increased sensitivity to hypotensive and sedative effect. Dose adjustments Start with small dose.
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Monitor blood counts and liver-function before treatment and at intervals during first 6–12 weeks or if unexplained fever occurs. l EFFECT ON LABORATORY TESTS Interference with laboratory tests. Positive direct Coombs’ test in up to 20% of patients (may affect blood cross-matching).
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There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: oral suspension, oral solution Tablet CAUTIONARY AND ADVISORY LABELS 3, 8 ▶Methyldopa (Non-proprietary) Methyldopa anhydrous 125 mg Methyldopa 125mg tablets | 56 tablet P £104.88 DT = £103.21 Methyldopa anhydrous 250 mg Methyldopa 250mg tablets | 56 tablet P £25.03 DT = £21.63 Methyldopa anhydrous 500 mg Methyldopa 500mg tablets | 56 tablet P £18.25 DT = £17.89 ▶Aldomet (Aspen Pharma Trading Ltd) Methyldopa anhydrous 250 mg Aldomet 250mg tablets | 60 tablet P £6.15 Cardiovascular system Methyldopa anhydrous 500 mg Aldomet 500mg tablets | 30 tablet P £4.55
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Driving and skilled tasks Drowsiness may affect performance of skilled tasks (e.g. driving); effects of alcohol may be enhanced.
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Initially 250 mg 2–3 times a day, dose should be
First-line fragment. Read the complete Indications and Dose section above.
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