Methyldopa

Methyldopa Brand Name– Aldomet

What is Methyldopa

Methyldopa is an oral and parenteral antihypertensive agent. An analog of 3,4-dihydroxyphenylalanine (DOPA), methyldopa originally was developed to inhibit DOPA carboxylase, an enzyme critical for the biosynthesis of catecholamines.

Methyldopa was later discovered to have antihypertensive activity, but its use as an antihypertensive agent has declined due to the development of other antihypertensive agents with a more favorable adverse side effect profile.

Methyldopa is the drug used most often in the treatment of chronic hypertension in pregnant women.

Methyldopa received FDA approval in December 1962.

Indications

  • hypertension
  • hypertensive emergency
  • hypertensive urgency

Side Effects

  1. agranulocytosis
  2. amenorrhea
  3. angina
  4. arthralgia
  5. azotemia
  6. bradycardia
  7. choreoathetosis
  8. cirrhosis
  9. colitis
  10. constipation
  11. depression
  12. diarrhea
  13. dizziness
  14. drowsiness
  15. edema
  16. ejaculation dysfunction
  17. elevated hepatic enzymes
  18. eosinophilia
  19. fever
  20. flatulence
  21. galactorrhea
  22. gynecomastia
  23. headache
  24. heart failure
  25. hemolysis
  26. hepatitis
  27. hyperkeratosis
  28. hyperprolactinemia
  29. hypotension
  30. impotence (erectile dysfunction)
  31. interstitial nephritis
  32. leukopenia
  33. libido decrease
  34. myalgia
  35. myocarditis
  36. nasal congestion
  37. nausea
  38. nightmares
  39. orgasm dysfunction
  40. pancreatitis
  41. paresthesias
  42. pericarditis
  43. psychosis
  44. rash
  45. sialadenitis
  46. thrombocytopenia
  47. toxic epidermal necrolysis
  48. urticaria
  49. vertigo
  50. vomiting
  51. weakness
  52. xerostomia

Monitoring Parameters

  • blood pressure
  • Coombs’ test
  • heart rate
  • hemoglobin/hematocrit
  • LFTs
  • red blood cell count (RBC)
  • serum creatinine/BUN

Contraindications

  • autoimmune disease
  • breast-feeding
  • cardiac disease
  • cerebrovascular disease
  • children
  • depression
  • dialysis
  • geriatric
  • hemolytic anemia
  • hepatic disease
  • hepatitis
  • MAOI therapy
  • mental status changes
  • Parkinson’s disease
  • pheochromocytoma
  • pregnancy
  • renal failure
  • renal impairment
  • sulfite hypersensitivity

Interactions

  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Propoxyphene
  • Acetaminophen; Pseudoephedrine
  • Acetazolamide
  • Acrivastine; Pseudoephedrine
  • Aldesleukin, IL-2
  • Alemtuzumab
  • Alfentanil
  • Alprazolam
  • Alprostadil
  • Amifostine
  • Amitriptyline; Chlordiazepoxide
  • Amlodipine; Celecoxib
  • Amoxapine
  • Amphetamine; Dextroamphetamine Salts
  • Amyl Nitrite
  • Apomorphine
  • Apraclonidine
  • Aripiprazole
  • Articaine; Epinephrine
  • Asenapine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Oxycodone
  • Atropine; Difenoxin
  • Atropine; Diphenoxylate
  • Baclofen
  • Belladonna; Opium
  • Benzodiazepines
  • Benzphetamine
  • Bortezomib
  • Bosentan
  • Brexpiprazole
  • Brompheniramine; Carbetapentane; Phenylephrine
  • Brompheniramine; Dextromethorphan; Phenylephrine
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Brompheniramine; Pseudoephedrine
  • Cabergoline
  • Cannabidiol
  • Carbetapentane; Chlorpheniramine; Phenylephrine
  • Carbetapentane; Diphenhydramine; Phenylephrine
  • Carbetapentane; Guaifenesin; Phenylephrine
  • Carbetapentane; Phenylephrine
  • Carbetapentane; Phenylephrine; Pyrilamine
  • Carbetapentane; Pseudoephedrine
  • Carbidopa; Levodopa
  • Carbidopa; Levodopa; Entacapone
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carbinoxamine; Phenylephrine
  • Carbinoxamine; Pseudoephedrine
  • Carbonic anhydrase inhibitors
  • Cariprazine
  • Celecoxib
  • Cenobamate
  • Cetirizine
  • Cetirizine; Pseudoephedrine
  • Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
  • Chlophedianol; Guaifenesin; Phenylephrine
  • Chlordiazepoxide
  • Chlordiazepoxide; Clidinium
  • Chloroprocaine
  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Phenylephrine
  • Chlorpheniramine; Pseudoephedrine
  • Chlorpromazine
  • Clonazepam
  • Clorazepate
  • Clozapine
  • Co-Enzyme Q10, Ubiquinone
  • Cocaine
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • COMT inhibitors
  • Degarelix
  • Desloratadine; Pseudoephedrine
  • Deutetrabenazine
  • Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Dexmethylphenidate
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Guaifenesin; Phenylephrine
  • Dextromethorphan; Guaifenesin; Pseudoephedrine
  • Dextromethorphan; Promethazine
  • Dextromethorphan; Quinidine
  • Diazepam
  • Diazoxide
  • Diclofenac
  • Diclofenac; Misoprostol
  • Diethylpropion
  • Diflunisal
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Diphenhydramine; Phenylephrine
  • Dobutamine
  • Dopamine
  • Duloxetine
  • Enflurane
  • Entacapone
  • Ephedrine
  • Epinephrine
  • Epoprostenol
  • Esketamine
  • Esomeprazole; Naproxen
  • Estazolam
  • Estradiol
  • Estradiol Cypionate; Medroxyprogesterone
  • Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
  • Ethinyl Estradiol; Norethindrone; Ferrous fumarate
  • Etodolac
  • Etomidate
  • Famotidine; Ibuprofen
  • Fenfluramine
  • Fenoprofen
  • Fentanyl
  • Fexofenadine; Pseudoephedrine
  • Fish Oil, Omega-3 Fatty Acids (Dietary Supplements)
  • Fluoxetine; Olanzapine
  • Fluphenazine
  • Flurazepam
  • Flurbiprofen
  • Fospropofol
  • Gabapentin
  • General anesthetics
  • Goserelin
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Guaifenesin; Phenylephrine
  • Guaifenesin; Pseudoephedrine
  • Haloperidol
  • Halothane
  • Histrelin
  • Homatropine; Hydrocodone
  • Hydralazine; Isosorbide Dinitrate, ISDN
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydromorphone
  • Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
  • Ibritumomab Tiuxetan
  • Ibuprofen
  • Ibuprofen; Oxycodone
  • Ibuprofen; Pseudoephedrine
  • Iloperidone
  • Iloprost
  • Indomethacin
  • Intravenous Lipid Emulsions
  • Iron
  • Iron Salts
  • Isocarboxazid
  • Isoflurane
  • Isoproterenol
  • Isosorbide Dinitrate, ISDN
  • Isosorbide Mononitrate
  • Ketamine
  • Ketoprofen
  • Ketorolac
  • Lansoprazole; Naproxen
  • Lasmiditan
  • Lemborexant
  • Leuprolide
  • Leuprolide; Norethindrone
  • Levocetirizine
  • Levodopa
  • Levorphanol
  • Linezolid
  • Lisdexamfetamine
  • Lithium
  • Lofexidine
  • Loratadine; Pseudoephedrine
  • Lorazepam
  • Lovastatin; Niacin
  • Lumateperone
  • Lurasidone
  • Maprotiline
  • Meclofenamate Sodium
  • Mefenamic Acid
  • Meloxicam
  • Meperidine
  • Meperidine; Promethazine
  • Mesoridazine
  • Mestranol; Norethindrone
  • Methadone
  • Methamphetamine
  • Methazolamide
  • Methenamine; Sodium Acid Phosphate
  • Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
  • Methylphenidate
  • Midazolam
  • Midodrine
  • Milrinone
  • Monoamine oxidase inhibitors
  • Morphine
  • Morphine; Naltrexone
  • Nabilone
  • Nabumetone
  • Naproxen
  • Naproxen; Pseudoephedrine
  • Naproxen; Sumatriptan
  • Nesiritide, BNP
  • Niacin, Niacinamide
  • Niacin; Simvastatin
  • Nitrates
  • Nitroglycerin
  • Nitroprusside
  • Nonsteroidal antiinflammatory drugs
  • Norepinephrine
  • Olanzapine
  • Opiate Agonists
  • Oxaprozin
  • Oxazepam
  • Oxycodone
  • Oxymetazoline
  • Oxymorphone
  • Paliperidone
  • Pentoxifylline
  • Perphenazine
  • Perphenazine; Amitriptyline
  • Pexidartinib
  • Phendimetrazine
  • Phenelzine
  • Phenothiazines
  • Phentermine
  • Phentermine; Topiramate
  • Phenylephrine
  • Phenylephrine; Promethazine
  • Piroxicam
  • Polysaccharide-Iron Complex
  • Potassium Phosphate; Sodium Phosphate
  • Prazosin
  • Pregabalin
  • Prilocaine; Epinephrine
  • Procainamide
  • Procaine
  • Prochlorperazine
  • Promethazine
  • Propofol
  • Propoxyphene
  • Pseudoephedrine
  • Quazepam
  • Quinidine
  • Rasagiline
  • Remifentanil
  • Riluzole
  • Risperidone
  • Rofecoxib
  • Selegiline
  • Sevoflurane
  • Silodosin
  • Sodium Ferric Gluconate Complex; ferric pyrophosphate citrate
  • Sodium Phosphate Monobasic Monohydrate; Sodium Phosphate Dibasic Anhydrous
  • Sufentanil
  • Sulindac
  • Temazepam
  • Tetrabenazine
  • Tetracaine
  • Thiethylperazine
  • Thioridazine
  • Thiothixene
  • Tizanidine
  • Tolbutamide
  • Tolcapone
  • Tolmetin
  • Tranylcypromine
  • Triazolam
  • Tricyclic antidepressants
  • Trifluoperazine
  • Triptorelin
  • Valdecoxib
  • Vasopressin, ADH
  • Vincristine Liposomal
  • Yohimbine
  • Ziprasidone