Methyldopa
CLINICAL USE
Hypertension
DOSE IN NORMAL RENAL FUNCTION
250 mg 2–3 times a day, increasing to a maximum dose of 3 g daily
PHARMACOKINETICS
Molecular weight :238.2 %Protein binding :<15 %Excreted unchanged in urine : 25–40 Volume of distribution (L/kg) :0.5half-life – normal/ESRD (hrs) :1.6–2/6–16 DOSE IN RENAL IMPAIRMENT
GFR (mL/MIN)
20 to 50 : Dose as in normal renal function and adjust according to response 10 to 20 : Dose as in normal renal function and adjust according to response <10 : Dose as in normal renal function and adjust according to response DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
CAPD :Dialysed. Dose as in GFR <10 : mL/min HD :Dialysed. Dose as in GFR <10 : mL/min HDF/high flux :Dialysed. Dose as in GFR <10 : mL/min CAV/VVHD :Probably dialysed. Dose as in GFR 10 to 20 mL/min IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugs Anaesthetics: enhanced hypotensive effect Antidepressants: avoid concomitant use with MAOIs Lithium: neurotoxicity (without increased plasma-lithium concentrations)Salbutamol: acute hypotension reported with salbutamol infusions ADMINISTRATION
Reconstition
– Route
Oral Rate of Administration
–Comments
– OTHER INFORMATION
Active metabolites with long half-life Interferes with serum creatinine measurementOrthostatic hypotension more common in renally impaired patients.
See how to identify renal failure stages according to GFR calculation
See how to diagnose irreversible renal disease
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