methyldopate (Aldomet ester)

Indications

• treatment of hypertension when parental administration is incidated
• treatment of hypertensive crisis

Dosage

• 250-500 mg IV infusion over 30-60 minutes every 6 hours
• maximum: 1000 mg every 6 hours

Injection: 50 mg/mL, 5 mL vials (250 mg/vial)

Adverse effects

• Cardiovascular:
  • aggravation of angina pectoris
  • congestive heart failure
  • prolonged carotid sinus hypersensitivity
  • paradoxical pressor response
  • orthostatic hypotension
  • edema
  • bradycardia
• GI:
  • pancreatitis
  • colitis
  • nausea, vomiting
  • diarrhea, constipation
  • sialadenitis, black tongue, xerostomia
  • abdominal distension, flatulence
• Hematologic:
  • bone marrow suppression
  • hemolytic anemia
• Hepatic:
  • hepatitis
  • jaundice
• Hypersensitivity:
  • myocarditis
  • pericarditis
  • vasculitis
  • lupus-like syndrome
  • drug-related fever
• CNS:
  • parkinsonism
  • Bell's palsy
  • decreased mental acuity
  • choreoathetosis
  • transient ishemic attack
  • nightmares
  • psychosis
  • depression
  • headache
  • sedation
  • asthenia or weakness
  • dizziness, lightheadedness
  • paresthesias
• Musculoskeletal:
  • arthralgia
  • myalgia
• Respiratory: nasal stuffiness
• Skin:
  • toxic epidermal necrolysis
  • rash
• Urogenital:
  • amenorrhea
  • gynecomastia, lactation
  • impotence, decreased libido

• drug adverse effects of adrenergic receptor agonists
• drug adverse effects of sympathomimetic(s)
• drug adverse effects of antihypertensive agents

Laboratory

• positive antinuclear antibody, LE cells
• positive rheumatoid factor
• abnormal liver function tests
• complete blood count
  • anemia
  • leukopenia
  • neutropenia
  • eosinophilia
  • thrombocytopenia
• positive Coombs test
• serum urea nitrogen may be increased
• serum prolactin: hyperprolactinemia

More general terms

• methyldopa (Aldomet)