Methyldopa
Methyldopa
MethyldopaPharmacological action
The antihypertensive preparation influencing the central mechanisms of regulation of a BP. Causes also moderate reduction of warm emission and the CARDIAC CONTRACTIONS RATE. The minute volume of blood changes a little. Enlarges rate of a glomerular filtration and a renal blood flow, reduces renin level in a blood plasma. Methyldopa moderate sedative an effect has. Can cause a delay of sodium and water in an organism.
The maximum hypotensive effect comes through 4-6 h after reception and proceeds 24-48 h.
Indications
- An arterial hypertensia (including at pregnant women).
Dosage regimen
Establish individually.
The adult prescribe in the first 2 days on 250 mg (1 tablet) in the evening, then a daily dose gradually enlarge (each 2 days by 250 mg) to 1-2 g (the maximum daily dose for adults) in 2-3 receptions, depending on expression of depression of a BP. At achievement of necessary stable hypotensive effect a daily dose gradually reduce (each 2 days by 250 mg) to a supporting, minimum effective dose.
Side effect
From party TSNS: a headache, giddiness, the general delicacy, drowsiness; seldom - a syndrome of a parkinsonism, hallucination.
From cardiovascular system: an orthostatic hypotension, a bradycardia, peripheric edemas.
From the alimentary system: a nausea, vomiting, insignificant dryness in a mouth, constipations, a diarrhoeia, a sialadenitis, a pancreatitis, disturbances of function of a liver with development of a cholestasia, an icterus.
From hemopoiesis system: seldom - a reversible leukopenia and a thrombocytopenia, an autoimmune hemolitic anaemia.
From endocrine system: a gynecomastia, a galactorrhea, potencies.
Allergic reactions: an exanthema.
The other: seldom - a fever, arthralgias.
Contraindications
- A pheochromocytoma;
- Acute and chronic diseases of a liver;
- Depression;
- Renal insufficiency;
- An autoimmune hemolitic anaemia;
- A porphyria;
- A hypersensibility to a preparation.
Pregnancy and lactemia
Methyldopa is a choice preparation at long therapy of an arterial hypertensia at pregnant women.
Alpha Methyldopum it is allocated with thoracal milk. In need of Methyldopa application in a lactemia it is necessary to supervise its effects at the newborn.
Special indicatings
At patients with disturbances of function of kidneys daily Methyldopa dose reduce.
At Methyldopa appointment as the patient of elderly and senile age it is necessary to observe strictly course of rising of a daily dose, as probably sharp depression of a BP.
It is necessary to consider, that after Methyldopa phase-out the hypotensive effect rather quickly stops, BP rising occurs usually during 48 h.
In cases of a delay of a liquid in an organism and occurrences of edemas at Methyldopa treatment preparation application in a combination to diuretics is shown, thus a preparation dose reduce: apply, for example, Methyldopa in a dose of 500 mg in a dose of 1 times/days At application in a combination with other hypotensive preparations (including blockers of slow calcium channels) daily Methyldopa dose also are recommended to be reduced of 50 mg.
Urine of the patients Methyldopa accepting, gets dark colour (reaction with an alpha-metildopoj and metabolites).
During Methyldopa treatment the alcohol use is forbidden.
The control of laboratory indicators
During Methyldopa treatment regular carrying out of the general analysis of blood and an estimation of function of a liver is recommended.
Overdosage
Symptoms: the expressed arterial hypotension, a tremor, a bradycardia, an intestine atony, vomiting, mental block.
Treatment: considering absence of specific antidotes, spend a gastric lavage (if preparation reception was recently); in cases when detoxicating begin through the big interval of time from the moment of Methyldopa reception to use a hemodialysis, than an artificial diuresis method more effectively.
Medicinal interaction
Methyldopa is not necessary to apply in a combination to inhibitors MAO because of intensifying of undesirable effects: are possible both an arterial hypotension, and the expressed hypertensia (crisis) with psychomotor excitation.
Conditions and periods of storage
The preparation should be stored at a room temperature (not above 25 C). The Period of validity - 5 years.
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