Methyldopa Disease Interactions

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.

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.

Methyldopa is removed by dialysis. Patients receiving methyldopa and undergoing dialysis may occasionally become hypertensive.

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

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.

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.

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.

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.