Methyldopa

About Methyldopa

Methyldopa is converted in the brain to alpha-methylnorepinephrine, which acts on central alpha receptors to lower blood pressure. Its effect peaks four to six hours after a dose. Doses change no more often than every two days, with increases usually added to the evening dose because drowsiness is common at first. The label states that reports of its use in all three trimesters suggest the possibility of harm to the baby appears remote.

The serious risks involve the blood and the liver. A positive direct Coombs test (antibodies on red blood cells) develops in a minority of people after six to twelve months, and rarely this leads to hemolytic anemia, which can be life-threatening. A liver reaction can show as fever, usually within the first three weeks, or as jaundice, and liver damage has rarely been fatal. Blood counts, a Coombs test and liver tests are recommended before starting and periodically. It is not used in active liver disease, after a past liver reaction to it, or with an MAO inhibitor.

Headache, weakness, swollen ankles and dry mouth are other side effects. MedlinePlus says older adults usually should not take it, as other medicines are safer. If it is stopped, blood pressure usually returns to its earlier level within one to two days, without overshooting. Mention it before a blood transfusion, which needs extra Coombs testing, and before lab tests, as it can distort some results.

Taking Methyldopa

How to take it

Two to four times a day at the same times each day. Drowsiness is common in the first few days and after a dose increase, so do not drive or use machinery until you know how it affects you.

If you miss a dose

Take it as soon as you remember, unless it is nearly time for your next dose; in that case skip the missed dose and carry on as usual. Never take two doses at once to make up.

Storage

At room temperature in a tightly closed, light-resistant container, out of reach of children.

Interactions to know about

It must not be taken with an MAO inhibitor. Iron tablets such as ferrous sulfate or ferrous gluconate reduce its absorption and are not recommended with it, so ask how to handle iron supplements or prenatal vitamins with iron. Lithium needs watching for toxicity, and anesthetics may need lower doses, so tell your surgeon or dentist. Report fever, yellowing skin or eyes, or unusual tiredness.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Methyldopa differs from pharmacy to pharmacy

Methyldopa is an old generic, but only a few companies still make it and some flat-price lists leave it out, so quotes depend on each pharmacy’s supplier and pricing.

Tablet count matters too. Maintenance doses run from 500 mg to 2 g a day in divided doses, and a dose made of two 250 mg tablets doubles the count compared with one 500 mg tablet.

Ways to pay less for Methyldopa without insurance

• Ask the prescriber to write each dose in the fewest tablets, such as one 500 mg tablet instead of two 250 mg tablets.
• Ask whether methyldopa is on the pharmacy’s flat-price generic list, and compare quotes from more than one pharmacy.
• Once the dose is stable, ask for a ninety-day supply from a pharmacy that can keep it in stock.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Methyldopa

1. 1.When are my blood count, Coombs test and liver tests due?
2. 2.Which symptoms mean I should call straight away?
3. 3.Can I take my iron supplement or prenatal vitamin with it?
4. 4.Is it safe while breastfeeding?
5. 5.When can I drive after starting or a dose change?

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