Methyldopa Disease Interactions
There are 8 disease interactions with methyldopa.
- Liver disease
- Cerebrovascular disease
- Dialysis
- Hemolytic anemia
- Leukopenia
- Peripheral edema
- Pheochromocytoma
- Psychoses
Methyldopa (applies to methyldopa) liver disease
Major Potential Hazard, High plausibility.
The use of methyldopa is contraindicated in patients with active liver disease, such as active hepatitis or active cirrhosis, and in patients with previous methyldopa- associated liver disorders. Hepatotoxicity is an uncommon but toxic effect of methyldopa. Therapy with methyldopa should be administered cautiously in patients with a history of or predisposition to liver disease.
References
- Goldstein GB, Lam KC, Mistillis SP "Drug-induced active chronic hepatitis." Dig Dis 18 (1973): 177-84
- Bonkowsky HL, Brisbane J "Colitis and hepatitis caused by methyldopa." JAMA 236 (1976): 1602-3
- Miller AC, Reid WM "Methyldopa-induced granulomatous hepatitis." JAMA 235 (1976): 2001-2
- Rodman JS, Deutsch DJ, Gutman SI "Methyldopa hepatitis: a report of six cases and review of the literature." Am J Med 60 (1976): 941-8
- Cacace LG, Cohen M "Alpha-methyldopa (aldomet) hepatitis." Drug Intell Clin Pharm 10 (1976): 144-52
- Sotaniemi EA, Hokkanen OT, Ahokas JT, et al. "Hepatic injury and drug metabolism in patients with alpha-methyldopa-induced liver damage." Eur J Clin Pharmacol 12 (1977): 429-35
- Thomas E, Rosenthal WS, Zapiach L, Micci D "Spectrum of methyldopa liver injury." Am J Gastroenterol 68 (1977): 125-33
- Puppala AR, Steinheber FU "Fulminant hepatic failure associated with methyldopa." Am J Gastroenterol 68 (1977): 579-81
- Bezahler GH "Case report: fatal methyldopa-associated granulomatous hepatitis and myocarditis." Am J Med Sci 283 (1982): 41-5
- Neuberger J, Kenna JG, Aria KN, Williams R "Antibody mediated hepatocyte injury in methyldopa induced hepatotoxicity." Gut 26 (1985): 1233-9
- Moses A, Zahger D, Amir G "Cholestatic liver injury after prolonged exposure to methyldopa." Digestion 42 (1989): 57-60
- Lawson DH, Gloss D, Jick H "Adverse reactions to methyldopa with particular reference to hypotension." Am Heart J 96 (1978): 572-9
- "Product Information. Aldomet (methyldopa)." Merck & Co., Inc (2001):
Methyldopa (applies to methyldopa) cerebrovascular disease
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: History - Cerebrovascular Disease
Rarely, involuntary choreoathetotic movements have been observed during therapy with methyldopa in patients with severe bilateral cerebrovascular disease. If these movements occur, therapy should be stopped.
References
- "Product Information. Aldomet (methyldopa)." Merck & Co., Inc (2001):
Methyldopa (applies to methyldopa) dialysis
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: hemodialysis
Methyldopa is removed by dialysis. Patients receiving methyldopa and undergoing dialysis may occasionally become hypertensive.
References
- Yeh BK, Dayton PG, Waters WC III "Removal of alpha-methyldopa (aldomet) in man by dialysis (35155)." Proc Soc Exp Biol Med 135 (1970): 840-3
- Myhre E, Brodwall EK, Stenbaek O, Hansen T "The renal excretion of methyldopa." Scand J Clin Lab Invest 29 (1972): 201-4
- Myhre E, Stenbaek O, Rugstad HE, et al. "Pharmacokinetics of methyldopa in renal failure and bilaterally nephrectomized patients." Scand J Urol Nephrol 16 (1982): 257-63
- "Product Information. Aldomet (methyldopa)." Merck & Co., Inc (2001):
Methyldopa (applies to methyldopa) hemolytic anemia
Moderate Potential Hazard, Low plausibility. Applicable conditions: Bleeding
Hemolytic anemia has occurred rarely during therapy with methyldopa and may be associated with a (+) direct Coombs. Therapy with methyldopa should be administered cautiously to patients with anemia or a predisposition to hemolytic syndromes. Clinical monitoring of hematopoietic function, including a baseline hematological profile, is recommended. If Coombs- positive hemolytic anemia occurs, the cause may be methyldopa and the drug should be discontinued
References
- Distenfeld A, Florita C, Gelfand ML "Hemolytic anemia induced by alpha-methyldopa." N Y State J Med Feb (1970): 570-3
- Nelson RB Jr, Nelson RB III "Methyldopa-associated intravascular hemolysis." Arch Intern Med 137 (1977): 1260-1
- Roy A, Ghosh ML "Coombs positive haemolytic anaemia due to methyldopa." Br J Clin Pract 35 (1981): 54, 58
- "Product Information. Aldomet (methyldopa)." Merck & Co., Inc (2001):
Methyldopa (applies to methyldopa) leukopenia
Moderate Potential Hazard, Low plausibility. Applicable conditions: Neutropenia
Rare reports of reversible reduction in white blood cell count, primarily neutrophils, have been noted. White blood cell counts returned to normal with discontinuation of methyldopa. Therapy with methyldopa should be administered cautiously in patients with a history of or predisposition to decreased white blood cell or neutrophil counts. Clinical monitoring of hematopoietic function is recommended.
References
- "Product Information. Aldomet (methyldopa)." Merck & Co., Inc (2001):
Methyldopa (applies to methyldopa) peripheral edema
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Congestive Heart Failure, Fluid Retention
Methyldopa may cause edema or weight gain associated with sodium retention. Therapy with methyldopa should be administered cautiously in patients adversely affected by sodium and water retention.
References
- Varkel Y, Braester A, Nusem D, Shkolnik T "Methyldopa-induced syndrome of inappropriate antidiuretic hormone-secretion and bone marrow granulomatosis." Drug Intell Clin Pharm 22 (1988): 700-1
- "Product Information. Aldomet (methyldopa)." Merck & Co., Inc (2001):
Methyldopa (applies to methyldopa) pheochromocytoma
Moderate Potential Hazard, Moderate plausibility.
Methyldopa causes fluorescence in urine samples at the same wave lengths as catecholamines, falsely high levels of urinary catecholamines may be reported. This will interfere with the diagnosis of pheochromocytoma. It is important to recognize this phenomenon before a patient with a possible pheochromocytoma is subjected to surgery. Methyldopa is not recommended for the treatment of patients with pheochromocytoma.
References
- Cregler LL, Mark H "Second-degree atrioventricular block and alpha-methyldopa: a probable connection." Mt Sinai J Med 54 (1987): 168-70
- Rosen B, Ovsyshcher IA, Zimlichman R "Complete atrioventricular block induced by methyldopa." Pacing Clin Electrophysiol 11 (1988): 1555-8
- "Product Information. Aldomet (methyldopa)." Merck & Co., Inc (2001):
Methyldopa (applies to methyldopa) psychoses
Minor Potential Hazard, Low plausibility. Applicable conditions: Psychosis
Rare symptoms of psychoses, such as hallucinations and delirium, and vivid dreams and nightmares have been reported during methyldopa therapy. Therapy with methyldopa should be administered cautiously to patients with a history of or predisposition to these conditions.
References
- Endo M, Hirai KO, Ohara M "Paranoid-hallucinatory state induced in a depressive patient by methyldopa: a case report." Psychoneuroendocrinology 3 (1978): 211-5
- Wurzelmann J, Frishman WH, Aronson M, et al. "Neuropsychological effects of antihypertensive drugs." Cardiol Clin 5 (1987): 689-701
- Labbate LA, Holzgang AJ "Manic syndrome after discontinuation of methyldopa." Am J Psychiatry 146 (1989): 1075-6
- Tchen P, Luchins DJ, Rose RP "Possibility of depression as a side effect of methyldopa." Am J Psychiatry 147 (1990): 128
- "Product Information. Aldomet (methyldopa)." Merck & Co., Inc (2001):
Methyldopa drug interactions
There are 249 drug interactions with methyldopa.
Methyldopa alcohol/food interactions
There is 1 alcohol/food interaction with methyldopa.
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Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
No interaction information available. |
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