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# Mylot%2525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252520at
## Overview
Mylot%2525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252520at (metyldopa) is an antihypertensive agent. Its mechanism of action is complex, believed to involve the formation of alpha-methylnorepinephrine in the brainstem, which inhibits sympathetic outflow.
## Primary Indications
* Hypertension
## Adult Dosing
The usual starting dose is 250 mg orally twice daily.
* **Maintenance:** Doses may be increased every 2 days or, more commonly, at intervals of not less than 5 days, until adequate blood pressure control is achieved.
* **Typical range:** 500 mg to 2 g daily in 2 to 4 divided doses.
* **Maximum:** 3 g daily.
## Pediatric Dosing
* **Initial:** 10 mg/kg/day orally in 2 to 4 divided doses.
* **Maximum:** 3 g/day. Dosing should be adjusted based on blood pressure response.
## Dose Adjustments
* **Renal Impairment:** Limited data available. Use with caution. Dose reduction may be necessary, but specific guidelines are not well-established.
* **Hepatic Impairment:** Use with caution. Monitor liver function closely.
## Contraindications
* Active liver disease
* Hypersensitivity to any component of the formulation
## Adverse Effects
* **Common:** Sedation, headache, dizziness, dry mouth, nausea, vomiting, constipation.
* **Serious:** Hemolytic anemia (positive direct Coombs test), hepatitis, drug-induced fever, parkinsonism, myocarditis, pericarditis, impotence.
## Key Drug Interactions
* **Other Antihypertensives:** Additive hypotensive effects.
* **Monoamine Oxidase Inhibitors (MAOIs):** Metyldopa can potentiate the pressor response to sympathomimetic amines and may cause severe hypertension when combined with MAOIs. Metyldopa should not be used in patients receiving MAOIs.
* **Iron Supplements:** May decrease absorption of metyldopa. Separate administration by at least 2 hours.
## Monitoring
* Blood pressure (supine and standing)
* Complete blood count (CBC) with differential (especially for hemolytic anemia)
* Liver function tests (LFTs)
* Direct Coombs test (baseline and periodically, especially with long-term therapy)
## Clinical Pearls
* Metyldopa is often considered a drug of choice for hypertension in pregnancy due to its safety profile.
* Sedation is common, particularly during initial therapy. Advise patients to avoid driving or operating machinery until they know how the medication affects them.
* Positive direct Coombs test can occur in up to 20% of patients on long-term therapy, but clinical hemolytic anemia is less frequent.
* Orthostatic hypotension may occur, especially at higher doses.
***
*This information is for educational purposes only and does not substitute for professional medical advice. Always consult with a qualified healthcare provider for any health concerns or before making any decisions related to your health or treatment. Please verify the most current prescribing information for Mylot%2525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252520at before use.*
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