Dopamet Adverse Reactions

Adverse effects of methyldopa are mostly consequences of its pharmacological action. Drowsiness is common, especially on initial and following an increase in dosage. Dizziness and lightheadedness may be associated with postural hypotension. Methyldopa is frequently associated with fluid pretension and edema, which responds to diuretics but may rarely progress to heart failure. Angina pectoris may be aggravated. Bradycardia, syncope, and prolonged carotid sinus hypersensitivity have been reported.
The mental neurological effects of methyldopa have included impaired concentration and memory, mild psychosis, depression, disturbed sleep and nightmares, paresthesias, bell's palsy, involuntary choreoathetopic movements and parkinsonism.
Methyldopa may produce gastrointestinal disturbances such as nausea and vomiting, diarrhea, constipation, and rarely pancreatitis and colitis. A black or sore tongue, and inflammation of the salivary glands have occurred, and dry mouth is quite common.
A positive Coomb's test may occur in 10 to 20% of all patients in prolonged therapy but only small proportion may develop hemolytic anemia. Other hypersensitivity effects have included myocarditis, fever, eosinophilia, and disturbances of liver function. Rashes, lichenoid and granulomatous eruptions, toxic epidermal necrolysis, flu-like syndrome, nocturia, uremia, nasal congestion, and retroperitoneal fibrosis. Hyperprolactinemia may occur, with breast enlargement or gynecomastia, galactorrhea, and amenorrhea. Hepatitis may develop particularly in the first 2 or 3 months therapy and is generally reversible in discontinuation but fatal hepatic necrosis as occurred. Antinuclear antibodies may develop and cases of lupus-like syndrome have been reported.
Treatment of Adverse Effects: Withdrawal of methyldopa or reduction in dosage causes the reversal of many side-effects. If overdosage occurs activated charcoal may be given or the stomach may be emptied by lavage. Treatment is largely symptomatic, but if necessary intravenous fluid infusion may be given to promote urinary excretion, and vasopressors given cautiously. Severe hypotension may respond to placing the patients in the supine position with the feet raised.