Generic drug of the therapeutic class: Cardiology and angiology
active ingredients: Methyldopa
laboratory: Msd Chibret
Case of 90
Moderate or severe hypertension.
Dosage ALDOMET 250 mg Coated tablet Case of 90
- In adults : usually start with 250 mg of methyldopa 2 or 3 times daily for the first 48 hours.
Then, adjust the daily dosage by increasing, if necessary, in increments of 48 hours at least, until a satisfactory therapeutic result is obtained. The usual dosage is 750 mg to 1.5 g / day, without exceeding 3 g per day.
Methyldopa can be started in most patients already treated with other antihypertensives by discontinuing these drugs, in a progressive manner if necessary. When methyldopa takes over from another antihypertensive agent, its dosage should initially be limited to no more than 500 mg per day, then increased as needed, with each dose increase to be separated from the previous dose by less 2 days.
- In children : administer at the beginning 10 mg / kg of body weight and per day, in 2 to 4 doses.
Then, adjust the dosage-increase or reduce doses-to obtain a satisfactory result. The maximum dosage is 65 mg / kg, without exceeding a total dose of 3 g / day.
Many patients experience a sedative effect at least at the beginning of treatment or when increasing the doses of the drug. Consequently, it seems desirable that the increase of the doses relates first to the catch of the evening.
This medicine MUST NOT BE USED in the following cases:
- hypersensitivity to any of the components of this medication,
- severe depressive state,
- history of drug-induced hepatitis or liver disorders associated with methyldopa,
- active liver disease such as acute and chronic hepatitis or cirrhosis,
- hemolytic anemia.
NOT RECOMMENDED :
This medication is generally not recommended when used with alcohol and alcohol-containing medicines.
The use of methyldopa is not recommended in patients with pheochromocytoma.
Aldomet side effects
The reactions reported are of order:
- Central neurological : usually transient sedative effect especially at the beginning of treatment or when increasing doses, headache, asthenia or weakness, paresthesia, Parkinson's syndrome, peripheral facial palsy, choreo-athetotic movements.
Psychic disorders with nightmares, disruption of mental acuity and reversible psychotic or depressive states.
Dizziness, feeling of empty head and symptoms of cerebrovascular insufficiency (may be related to lowering of blood pressure).
- cardiovascular : orthostatic hypotension, bradycardia, aggravation of angina pectoris.
Edema (and weight gain) usually regressed by a diuretic (stop treatment with methyldopa if edema increases or if signs of heart failure appear).
- digestive : nausea, vomiting, abdominal bloating, constipation, flatulence, diarrhea, colitis, moderate dryness of the mouth, saburo or "black" tongue, pancreatitis, inflammation of the salivary glands.
- haematological : Coombs positive test, haemolytic anemia, bone marrow suppression, leukopenia, granulocytopenia, thrombocytopenia, presence of antinuclear antibodies, LE cells and rheumatoid factor; eosinophilia is exceptional.
- allergic : drug fever and abnormal liver function tests with jaundice and hepatocellular lesions, lupus syndrome, myocarditis, pericarditis.
- hepatic : acute cytolytic hepatitis, active chronic hepatitis, jaundice, with or without fever, during the first 2 or 3 months of treatment. This jaundice is usually due to hepatocellular necrosis. Some rare cases have been reported. Liver biopsies in several patients with hepatic functional impairment revealed microscopic focal necrosis consistent with drug hypersensitivity. In some cases, cholestatic jaundice has been observed.
- dermatological : cutaneous signs of the eczematous or lichenoid type; toxic epidermal necrosis.
- various : nasal congestion, elevated blood urea, swelling of the breasts, gynecomastia, galactorrhea, hyperprolactinemia, amenorrhea, sexual impotence, decreased libido, discrete arthralgia with or without swelling of the joint, myalgia.