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Generic Name

Methyldopa (Aldomet)

Dosage/ Frequency
250 mg 1 tab q 8 hours

Classification
Antihypertensive Sympatholytic (centrally acting)

Indication
Hypertension IV methyldopate: Acute hypertensive crisis; not drug of choice because of slow onset of action Unlabeled use: Hypertension of pregnancy

Contraindicatio n
Contraindicated with hypersensitivity to methyldopa, active hepatic disease, previous methyldopa therapy associated with liver disorders. Use cautiously with previous liver disease, renal failure, dialysis, bilateral cerebrovascular disease, pregnancy, lactation.

Side Effects CNS: Sedation,

Nrsg. Responsibilities Warning Monitor

headache, asthenia, weakness (usually early and transient), dizziness, lightheadedness, symptoms of cerebrovascular insufficiency, paresthesias, parkinsonism, Bell palsy, decreased mental acuity, involuntary choreoathetotic movements, psychic disturbances. CV: Bradycardia, prolonged carotid sinus hypersensitivity, aggravation of angina pectoris, paradoxical pressor response, pericarditis, myocarditis, orthostatic hypotension, edema. Dermatologic: Rash seen as eczema or lichenoid eruption,toxic epidermal necrolysis fever, lupuslike syndrome

hepatic function, especially in the first 6-12 week of therapy or if unexplained fever appears, abnormalities in liver function tests, or jaundice occurs. Ensure that methyldopa is not reinstituted in such patients. Warning Monitor blood counts periodically to detect hemolytic anemia; a direct Coombs tets before therapy and 612 mo may be helpful. Discontinue drug if Coombspositive hemolytic anemia occurs. If hemolytic anemia is related to methyldopa, ensure that drug is not reinstituted. Warning Discontinue therapy if involuntary

Endocrine: Breast

enlargement, gynecomastia, lactation, hyperprolactinemia, amenorrhea, galactorrhea, decreased libido GI: Nausea, vomiting, distention, constipation, flatus, diarrhea, colitis, dry mouth, sore or black tongue, pancreatitis, sialadenitis, abnormal liver function tests, jaundice, hepatitis, hepatic necrosis. Hematologic: Positive Coombs test, hemolytic anemia, bone marrow depression, leucopenia, granulocytopenia, thrombocytopenia, positive tests for antinuclear antibody, lupuslike syndrome, and rheumatoid factor Other: Nasal stuffiness, mild arthralgia, myalgia, septic shock-like syndrome

choreoathetotic movements occur. Warning Discontinue if edema progresses or signs of HF occur. Add a thiazide to drug regimen or increase dosage of methyldopa tolerance occurs (second and third month of therapy) Warning Monitor BP carefully when continuing methyldopa; drug has short duration of action, and hypertension usually returns within 48 hours.