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Methyldopa is an FDA-approved medication used to treat high blood pressure (hypertension). It works by reducing chemicals in the body that tighten blood vessels, allowing smoother blood flow and lowering blood pressure. Methyldopa is especially beneficial for managing hypertension during pregnancy, ensuring safety for both mother & baby. Available in injectable solutions (50mg/mL) and tablet forms (250mg and 500mg), it is typically taken two to four times daily. Common side effects consist of drowsiness, headache, dizziness, and nausea. Serious side effects, such as liver problems and severe allergic reactions, should be monitored. Methyldopa should be stored at room temperature, away from moisture and light. Consult your healthcare expert for proper dosage and potential interactions with other medications.

Methyldopa Overview

Methyldopa is an FDA-approved medication primarily used to treat high blood pressure (hypertension). Methyldopa, the primary active ingredient, functions by lowering the levels of certain chemicals in the body that constrict blood vessels. This action facilitates smoother blood flow and consequently reduces blood pressure. This is particularly beneficial in treating hypertension during pregnancy, reducing risks to both mother and baby without compromising safety. Available in injectable solutions (50mg/mL) and tablet forms (250mg and 500mg). It is typically taken two to four times daily, with or without food, but consistency in timing is essential. Swallow the tablets whole with a full glass of water. 

Methyldopa is suitable for adults, including pregnant women, who need to manage their blood pressure levels effectively. The medication is converted in the brain to alpha-methylnorepinephrine, which helps lower nerve signals that increase blood pressure, thus effectively managing hypertension. Common side effects of methyldopa indicate drowsiness, headache, dizziness, dry mouth, nausea, and diarrhea. Serious side effects can include liver problems, severe allergic reactions, unusual bleeding or bruising, mental/mood changes, and severe dizziness. It is essential to monitor for these side effects & consult with a medical expert if they occur.

Precautions include not using methyldopa if you are allergic to it, if you have liver disease, or if you have taken an MAO inhibitor in the past 14 days. Pregnant & breastfeeding women should consult their doctor about potential risks. If you miss a dose, take it as soon as you remember unless it is close to the next dose. In case of an overdose, seek medical attention right away. Methyldopa should be stored at room temperature, away from moisture and light, and kept out of reach of children. Dispose of it properly when it is expired or no longer needed. Methyldopa can interact with various medications, so inform your medical expert about any other drugs you are taking to avoid adverse interactions.

Uses of Methyldopa 

  • High blood pressure

Methyldopa Dosage

Methyldopa comes in the following forms and dosages.

Injectable Solution

  • 50mg/mL


  • 250mg
  • 500mg

Recommended Dosage for Different Patients 


  • Typically, the initial dose for treating hypertension in adults is 250 mg two or three times a day.
  • Depending on the patient’s response, the dosage may be increased every two days until the desired blood pressure control is achieved. The usual maintenance dose ranges from 500 mg to 2 grams daily, divided into two to four doses.


  • Due to potentially reduced kidney function, elderly patients may require lower initial doses and gradual adjustments to minimize side effects.

Pregnant Women:

  • Methyldopa is commonly used for managing hypertension during pregnancy. The dosages are similar to those of other adults but should be carefully monitored by a healthcare provider.


  • The use of Methyldopa in children is less common and should be under strict medical supervision. If prescribed, doses are typically calculated based on body weight.

Patients with Renal Impairment:

  • Patients with kidney dysfunction may require lower dosages or less frequent dosing due to the slower excretion of the medication.

[Note: These recommendations may vary from person to person. Consult with your doctor, who will customize your dosage based on your specific needs.]

How to Take Methyldopa?

  • Take methyldopa precisely as prescribed by your doctor.
  • Typically, it is taken two to four times daily.
  • You can take it with or without food, but consistency is critical.
  • Swallow the tablets whole with a full glass of water.
  • Do not crush or chew the tablets unless suggested by your medical expert.
  • Do not stop taking methyldopa suddenly without consulting your doctor.

[Note: Your doctor will determine the appropriate dosage for you based on your medical condition and treatment response, adhering to clinical guidelines and research. Adjustments may be made over time as necessary.]

How Does Methyldopa Work?

Methyldopa reduces the amount of certain substances in the body that constrict blood vessels and raise blood pressure. It is converted into a chemical called alpha-methylnorepinephrine in the brain, decreasing the nerve signals that increase blood pressure. This results in lowered blood pressure levels. Methyldopa is effective in treating hypertension, especially in pregnant women, by mitigating risks to both mother and baby without compromising safety.

Methyldopa Side Effects

Common side effects of Methyldopa may include:

  • Drowsiness or tiredness
  • Headache
  • Weakness
  • Dizziness
  • Lightheadedness
  • Dry mouth
  • Constipation
  • Nausea
  • Vomiting
  • Diarrhea
  • Loss of appetite
  • Stuffy nose
  • Slow heart rate
  • Swelling of hands, feet, or ankles
  • Mild fever
  • Decreased sexual ability

Serious side effects of Methyldopa may include:

  • Liver problems (yellowing of skin/eyes, dark urine, severe abdominal pain)
  • Severe allergic reactions 
  • Unusual bleeding or bruising
  • Signs of infection (fever, persistent sore throat)
  • Mental/mood changes (depression, anxiety)
  • Chest pain
  • Slow/irregular/fast heartbeat
  • Severe dizziness or fainting
  • Numbness/tingling of hands/feet
  • Unexplained muscle pain, tenderness, or weakness
  • Unusual tiredness
  • Swollen lymph nodes
  • Signs of kidney problems (change in urine amount)
  • Severe stomach/abdominal pain
  • Persistent nausea/vomiting

[Note: This list may not encompass all possible side effects of Methyldopa. Always consult your healthcare provider for detailed medical advice regarding side effects.]

Methyldopa Warnings

  • Not for Initial Therapy: Methyldopa/hydrochlorothiazide is not intended for initial blood pressure therapy. Your healthcare provider will start you on methyldopa and hydrochlorothiazide separately, adjusting your doses based on your response and blood pressure levels.
  • Electrolyte Imbalance: This medication can cause imbalances in electrolytes like sodium, chloride, potassium, and magnesium, which can sometimes be dangerous. The risk is higher if you are dehydrated, vomiting, or taking other medications affecting electrolytes. Consult your provider about any medicines, supplements, or foods affecting electrolyte levels. Seek medical help if you experience dry mouth, extreme thirst, weakness, tiredness, sleepiness, restlessness, confusion, seizures, muscle pain or cramps, low blood pressure, trouble urinating, irregular heartbeat, nausea, or vomiting.
  • Hemolytic Anemia: Long-term use of methyldopa/hydrochlorothiazide can lead to a positive Coombs test, indicating your body is attacking its red blood cells. This usually occurs between 6 and 12 months of treatment. This uncommon condition may progress into hemolytic anemia, characterized by the rapid destruction of red blood cells faster than they can be produced. Regular blood tests will be required if you are on long-term treatment.
  • Liver Problems: Although rare, methyldopa/hydrochlorothiazide can cause serious liver issues. If you have a history of liver problems, discuss alternative medications with your provider. Report any fever or symptoms of liver damage, such as unusual vomiting, pale stools, dark urine, stomach pain, or yellowing of the eyes & skin immediately.
  • Low White Blood Cell Count: Methyldopa/hydrochlorothiazide can temporarily lower your white blood cell count, affecting your immune system and making it harder to fight infections. This issue usually resolves once you stop the medication.
  • Gout: This medication can increase uric acid levels, potentially causing or worsening gout.
  • High Blood Sugar Levels: Methyldopa/hydrochlorothiazide may raise blood sugar levels. If you have diabetes, keep your blood sugar closely in check and inform your provider so they can adjust your diabetes medications as necessary.

Methyldopa Precautions

  • Do not use methyldopa if you are allergic to it.
  • Kidney disease (or if you are on dialysis).
  • Avoid using methyldopa if you have liver disease, notably cirrhosis, or if you have a history of liver problems caused by methyldopa.
  • Avoid taking methyldopa if you have used an MAO inhibitor within the last 14 days due to the risk of serious drug interactions. Examples of MAO inhibitors are isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, and tranylcypromine, among others.
  • Heart disease or angina (chest pain)
  • Liver disease
  • A heart attack or stroke
  • Inform your healthcare specialist if you are pregnant or plan to become pregnant. It is not known if methyldopa will harm an unborn baby. However, untreated high blood pressure during pregnancy can cause complications such as diabetes or eclampsia, which are dangerous for both mother and baby. The benefits of treating hypertension may outweigh the risks to the baby.
  • It may be risky to breastfeed while using methyldopa. Consult your doctor about any potential risks.

Methyldopa Contraindications 

  • Current liver problems
  • History of liver issues due to previous methyldopa use
  • Anuria (inability to produce urine)
  • Taking monoamine oxidase (MAO) inhibitors
  • Allergy to sulfonamide medications

Methyldopa Missed Dose

If you miss a dose of methyldopa, take it as soon as you remember. If it’s almost time for your next dosage, skip the missed dose and take your next scheduled dose. Do not take more of this medication to compensate for the missed dosage. Consistency is critical, so try to take your medicines simultaneously each day. If you are unsure, consult your doctor or pharmacist.

[Note: If you’ve missed a dose of your medication and are uncertain about the timing for your next dose, promptly consult your doctor or pharmacist for guidance.]

Methyldopa Overdose 

If you suspect an overdose of methyldopa, seek immediate medical attention. Symptoms of overdose may comprise of severe drowsiness, weakness, slow heartbeat, dizziness, fainting, or seizures. Do not delay getting help, as an overdose can be severe. Call your local emergency number or the Poison Help line at 1-800-222-1222 for guidance. Keep methyldopa out of reach of children to prevent accidental overdose.

[Note: If you have taken more than the recommended dosage, seek immediate medical assistance or contact the Poison Help line at 1-800-222-1222.]

Methyldopa Storage

  • Store methyldopa at room temperature, between 68°F to 77°F.
  • Keep methyldopa in its original container, tightly closed, to protect it from moisture and light.
  • Store the medication in a dry place away from excess heat and moisture. Avoid storing it in the bathroom.
  • Keep methyldopa out of reach of children and pets to prevent accidental ingestion.
  • Do not flush methyldopa down the toilet or pour it into a drain unless asked to do so. Dispose of it properly when it is expired or no longer needed. Consult your medical expertise or local waste disposal company for safe disposal methods.
  • Regularly check the expiration date, and do not use methyldopa past its expiration date.

[Note: Consult with your healthcare professional to learn how to properly dispose of unused medicine and address any storage questions you may have.]

Methyldopa Interactions

  • Monoamine Oxidase Inhibitors (MAOIs): Combining methyldopa with MAOIs can significantly increase blood pressure.
  • Beta-Blockers: These medications can enhance the blood pressure-lowering effects of methyldopa, potentially causing hypotension.
  • Lithium: Methyldopa can increase lithium levels in the blood, leading to lithium toxicity.
  • Iron Supplements: Iron can reduce the absorption of methyldopa, decreasing its effectiveness. Taking methyldopa at least 2 hours before or after iron supplements is recommended.
  • Other Antihypertensive Drugs: Methyldopa’s blood pressure-lowering effects may be increased with other antihypertensives, requiring dose adjustments.
  • Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): These drugs may reduce the effectiveness of methyldopa in controlling blood pressure.
  • Anesthetics: Methyldopa can enhance the hypotensive effects of anesthetic agents.
  • Tricyclic Antidepressants (TCAs): These medications can decrease the antihypertensive effects of methyldopa.
  • Levodopa: Combining methyldopa with levodopa may increase the risk of side effects such as drowsiness and confusion.
  • Corticosteroids: These can reduce the effectiveness of methyldopa in controlling blood pressure.


[Note: This list of drug interactions with Methyldopa is not exhaustive. Inform your medical expert of all medications that you currently use, including prescription, over-the-counter & herbal products.]

Methyldopa Alternatives

[Note: Your healthcare professional will determine the most appropriate medication for you. Avoid using any alternative drugs without professional advice, as self-medicating could lead to severe side effects.]

Frequently Asked Questions

Is Methyldopa safe for pregnant women?

Yes, Methyldopa is safe for treating high blood pressure during pregnancy. It is not known to cause harm to unborn babies and can prevent life-threatening complications for both mothers and their babies.

Is it safe to drink alcohol while taking Methyldopa?

Drinking alcohol while on Methyldopa can significantly lower your blood pressure, especially when changing positions. Consult your healthcare expert before starting this medication if you consume alcohol frequently or in large quantities to determine if it’s suitable for you.

Does Methyldopa cause drowsiness?

Methyldopa can induce drowsiness, particularly when initiating treatment or adjusting the dosage. Therefore, refrain from driving or engaging in activities that demand focus until you understand its impact on you.

Can Methyldopa be taken together with other blood pressure medications?

Some individuals may require multiple medications to manage their blood pressure effectively. Depending on your health status and blood pressure readings, your healthcare provider may prescribe a combination of therapies. When Methyldopa is used alongside other blood pressure medications, its effects can be potentiated. Monitoring for any side effects or deficient blood pressure levels during treatment is essential.

Does Methyldopa cause depression?

Depression can be a potential side effect of Methyldopa. Although it generally does not increase the risk of depression in most users, it is associated with a heightened risk of postpartum depression in pregnant individuals who use Methyldopa. If you notice any shifts in your mood or behavior after starting this medication, it’s important to discuss them with your healthcare expert promptly.

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