L-Methyldopa Teva (Methyldopa)

Methyldopa is used primarily in the management of hypertension, acting on central sympathetic pathways.

• Essential hypertension: reduces systolic and diastolic blood pressure in adults with primary hypertension.
• Pregnancy‑induced hypertension: controls blood pressure in preeclampsia and gestational hypertension.
• Chronic hypertension: provides stable long‑term blood pressure control when other agents are unsuitable.

• Methyldopa is converted in the body to alpha‑methyldopamine, which stimulates central alpha‑2 adrenergic receptors in the medulla. Activation of these receptors decreases sympathetic nerve activity, leading to reduced peripheral vascular resistance and lower heart rate, thereby lowering systemic blood pressure.

Methyldopa may cause a range of adverse reactions, from mild to serious.

Common Side Effects

• Drowsiness: feeling unusually sleepy or fatigued.
• Dry mouth: reduced salivation causing a parched sensation.
• Nasal congestion: blockage or stuffiness of the nasal passages.
• Headache: mild to moderate pain in the head.
• Gastrointestinal upset: nausea, vomiting or abdominal discomfort.
• Orthostatic hypotension: dizziness upon standing.

Serious or Rare Side Effects

• Liver dysfunction: elevated liver enzymes or hepatitis.
• Hemolytic anemia: destruction of red blood cells leading to fatigue.
• Lupus‑like syndrome: joint pain, rash and fever.
• Severe hypotension: dangerously low blood pressure requiring medical attention.
• Depression or suicidal thoughts: mood changes that may need psychiatric evaluation.
• Allergic reactions: rash, itching, swelling or breathing difficulty.

When prescribing methyldopa, clinicians should consider several safety measures.

• Blood pressure monitoring: check regularly to avoid excessive hypotension.
• Liver function tests: assess hepatic enzymes before and during therapy.
• Complete blood count: monitor for signs of hemolytic anemia.
• Depression screening: watch for mood changes, especially in patients with a history of psychiatric illness.
• Discontinuation: taper gradually to prevent rebound hypertension.
• Store at below 25°C: keep in the original container, protect from moisture and direct sunlight.

Methyldopa can interact with several other medicines, requiring careful management.

Major Interactions (Avoid)

• MAO inhibitors: may cause hypertensive crisis.
• Direct-acting sympathomimetics: can blunt the antihypertensive effect.
• Antihypertensive combinations: increase risk of severe hypotension.

Moderate Interactions (Monitor Closely):\n- CNS depressants: may enhance drowsiness.

• Iron supplements: can reduce methyldopa absorption if taken simultaneously.
• Lithium: may increase lithium levels, necessitating serum monitoring.