Methyl Dopa
Synonym :
Methyldopa
Mechanism :
It is a centrally acing antihypertensive agent that acts on the central alpha receptors and is used in the treatment of mild to moderate hypertension.
Indication :
- Treatment of refractory hypertension
- Hypertensive crisis
Contraindications :
Active liver disease, pheochromocytoma, porphyria.
Dosing :
Hypertension:
<12 years: 2.5 mg/kg PO thrice a day
12-18 years: 10 mg/kg/day PO in 2 divided doses.
Initial doses is to be increased at intervals of 2 or more days to a maximum of 15 mg/kg 3 times daily in neonates; 5 mg/kg/day or 3 g/day in older children and adults.
Hypertensive crisis:
20-40 mg/kg/day IV in 4 divided doses. Max dose: 65 mg/kg/day or 3 g/day.
Adverse Effect :
Sedation, dizziness, depression, lethargy, dry mouth, reduced mental capacity, rash, gynecomastia, galactorrhoea, impotence, arthralgia, nasal stuffiness, weight gain and postural hypotension. Positive Coombs test, thrombocytopenia, cholestatic liver damage, bradycardia may also be seen.
Interaction :
Potentiation of other antihypertensives.
NSAIDS: Antagonise the antihypertensive effect.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function and adjust according to response |
| 10-20 | Dose as in normal renal function and adjust according to response |
| <10 | Dose as in normal renal function and adjust according to response |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Dialysed. Dose as in GFR<10 mL/ min |
| HD | Dialysed. Dose as in GFR<10 mL/ min |
| HDF/High flux | Dialysed. Dose as in GFR<10 mL/ min |
| CAV/VVHD | Probably dialysed. Dose as in GFR=10–20 mL/min |
Hepatic Dose :
Use is contraindicated in patients with active hepatic disease.