Methyldopa/hydrochlorothiazide | Side Effects & More
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Generic Name:

hydrochlorothiazide-methyldopa, Oral tablet

All Brands

  • Aldoril (Discontinued)
  • Aldoril D (Discontinued)
A discontinued drug is a drug that has been taken off the market due to safety issues, shortage of raw materials, or low market demand.
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Highlights for hydrochlorothiazide-methyldopa

Oral tablet
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Methyldopa/hydrochlorothiazide is a combination of two drugs is a single form that’s used to treat high blood pressure (hypertension). This drug shouldn’t be used as your first treatment for high blood sugar. It’s given after other medications haven’t worked.

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The standard starting dose is 250 mg methyldopa/15 mg hydrochlorothiazide taken by mouth 2–3 times per day or 250 mg methyldopa/25 mg hydrochlorothiazide taken two times per day.

3

This drug may cause drowsiness. This is more likely to happen when you first start taking it or during dose increases. 

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Common side effects include dizziness, headache, muscle weakness, nausea, diarrhea, or vomiting.

5

People with certain conditions, such as liver or kidney problems, gout, diabetes, or lupus, may not be able to take this drug. 

IMPORTANT INFORMATION

FDA warning

This drug has a Black Box Warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to potentially dangerous effects.

Not a first treatment for high blood pressure. This drug shouldn’t be used as a first treatment for high blood pressure. Your doctor should decide your dose of each drug in this combination before giving you methyldopa/hydrochlorothiazide.

Who shouldn't use this drug?

You shouldn’t use this drug if you have certain conditions or take certain medicines. Don’t take methyldopa/hydrochlorothiazide if you:

  • have liver disease, including acute hepatitis or active cirrhosis
  • don’t produce urine
  • are allergic to sulfa drugs
  • are taking monoamine oxidase inhibitors (MAOIs), such as isocarboxazid (Marplan), phenelzine(Nardil), selegiline (Emsam),or tranylcypromine (Parnate).

Blood disorder

Methyldopa/hydrochlorothiazide may cause a fatal blood disorder, such as hemolytic anemia. This drug can also cause severe liver problems. Your doctor will monitor you for these problems while you’re taking this drug.

Fluid and electrolytes imbalance

Use this drug with caution if you have kidney or liver problems. Methyldopa/hydrochlorothiazide can cause you to lose too much magnesium, salt, potassium, and chloride. These chemical imbalances can cause other problems.

Drug features

Methyldopa/hydrochlorothiazide is a prescription drug. It’s only available as a generic drug. It’s available as an oral tablet.

This is a combination drug. It contains 2 drugs: methyldopa and hydrochlorothiazide. It’s important to know about all the drugs in the combination because each drug may affect you in a different way.

Methyldopa/hydrochlorothiazide may be taken in combination with other blood pressure-lowering drugs.

Why it's used

Methyldopa/hydrochlorothiazide is used to treat high blood pressure in adults.

How it works

Methyldopa belongs to a class of drugs called centrally acting antiadrenergics. Hydrochlorothiazide belongs to a class called thiazide diuretics.

More Details

How it works

Methyldopa belongs to a class of drugs called centrally acting antiadrenergics. Hydrochlorothiazide belongs to a class called thiazide diuretics. A class of drugs refers to medications that work similarly. They have a similar chemical structure and are often used to treat similar conditions.

Methyldopa works by activating receptors, called alpha receptors. This helps lower your blood pressure. It’s thought that hydrochlorothiazide works to remove excess salt and water from your body. This keeps your heart from working as hard to pump blood. This lowers your blood pressure levels. 

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hydrochlorothiazide-methyldopa Side Effects

Oral tablet

More Common Side Effects

Some of the more common side effects that occur with methyldopa/hydrochlorothiazide include:

  • dizziness

  • headache

  • muscle weakness

  • nausea

  • diarrhea

  • vomiting

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Heart problems. Symptoms include:

    • chest pain
    • low blood pressure, which may cause lightheadedness
    • dizziness
    • swelling of your ankles
    • shortness of breath
  • Blood problems. Symptoms include:

    • frequent infections or infections that don’t go away
    • bruising more easily than normal
    • bleeding from your gums or nosebleeds
    • severe tiredness or weakness
    • red or purple spots on your body
  • Serious allergic reactions. Symptoms include:

    • fever
    • sharp chest pain
    • skin rash
    • weight loss
    • numbness or weakness
    • trouble breathing
  • Liver problems. Symptoms include:

    • yellowing of your skin and the whites of your eyes
    • dark-colored urine
  • Blood chemicals imbalance. Symptoms include:

    • thirst
    • weakness
    • confusion
    • seizures
    • muscle cramps
    • fast heart rate
    • nausea or vomiting
  • Systemic lupus erythematosus, a condition in which your immune system attacks parts of your body. Symptoms may include:

    • skin rash, commonly in the shape of a butterfly across your nose
    • hair loss
    • tiredness
    • joint pain
Pharmacist's Advice
Healthline Pharmacist Editorial Board

Methyldopa/hydrochlorothiazide may cause drowsiness. This is more likely to happen when you first start taking it or during dose increases.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
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hydrochlorothiazide-methyldopa May Interact with Other Medications

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Methyldopa/hydrochlorothiazide can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Alcohol interaction

Using alcohol while taking this drug can cause a sedative effect. This means your reflexes can be slowed, you could have poor judgment, and you could become sleepy, which can be dangerous.

Medications that might interact with this drug

Blood pressure drugs

Taking this drug with other medicines that lower your blood pressure can raise your risk of low blood pressure (hypotension).

These drugs include:

  • lisinopril
  • amlodipine
  • valsartan
  • atenolol

Cholesterol-lowering drugs

These drugs can decrease the amount of methyldopa/hydrochlorothiazide in your body. This means that it may not work as well. 

These drugs include:

  • cholestyramine
  • colestipol

Depression drugs

You shouldn’t take methyldopa/hydrochlorothiazide with monoamine oxidase inhibitors.

These drugs include:

  • isocarboxazid (Marplan)
  • phenelzine (Nardil)
  • selegiline (Emsam)
  • tranylcypromine (Parnate)

Iron supplements

You shouldn’t take iron supplements with this drug. Iron may decrease the amount of methyldopa/hydrochlorothiazide that’s active in your body. This means that it may not work as well to lower your blood pressure.

Lithium

Methyldopa/hydrochlorothiazide can cause lithium levels to increase to toxic levels in your body.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

People with liver disease

You shouldn’t take this drug if you have liver disease. It can cause changes in your fluid and electrolytes. This may lead to a coma if you have liver disease.

People with kidney disease

If you have kidney disease, you have a higher risk of serious side effects caused by this drug. Your doctor will monitor your kidney function and adjust your medication as needed.

People with systemic lupus erythematosus

This drug can cause new or worsening symptoms of lupus. Call your doctor right way if this occurs.

People with bronchial asthma

If you have asthma, you’re more likely to experience a hypersensitivity reaction, such as an allergic reaction or systemic lupus erythematosus.

People with gout

This drug may increase the level of uric acid in your body and make your gout worse.

People with diabetes

Your doctor may adjust the doses of your diabetes drugs while you’re taking this medicine. Methyldopa/hydrochlorothiazide may cause your blood sugar level to increase.

Pregnant women

Methyldopa/hydrochlorothiazide is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should only be used if the potential benefit justifies the potential risk to the fetus.

Women who are breast-feeding

Methyldopa/hydrochlorothiazide may pass into breast milk and may cause side effects in a child who is breast-fed.

Talk to your doctor if you breast-feed your baby. You may need to decide whether to stop breast-feeding or stop taking this medication.

For seniors

Older adults may process drugs more slowly. A normal adult dose may cause levels of this drug to be higher than normal in your body. If you’re a senior, you may need a lower dose or a different schedule.

For children

This medicine hasn’t been studied in children and shouldn’t be used in children under the age of 18 years.

Allergies

Methyldopa/hydrochlorothiazide can cause a severe allergic reaction. Symptoms include:

  • trouble breathing
  • swelling of your throat or tongue
  • hives
  • rash

Don’t take this drug again if you’ve ever had an allergic reaction to it or other sulfonamide drugs (more commonly know as sulfa drugs). Taking it again could be fatal (cause death). 

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How to Take hydrochlorothiazide-methyldopa (Dosage)

Oral tablet

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Hypertension

Brand: methyldopa/hydrochlorothiazide

Form: Oral tablet
Strengths: 
  • 250 mg methyldopa/15 mg hydrochlorothiazide
  • 250 mg methyldopa/25 mg hydrochlorothiazide
Adult dosage (ages 18–64 years)
  • Starting dose: 250 mg methyldopa/15 mg hydrochlorothiazide taken by mouth 2–3 times per day or 250 mg methyldopa/25 mg hydrochlorothiazide taken twice per day.
  • Some people will need additional methyldopa without extra hydrochlorothiazide. Your doctor will decide if this is necessary for you. If so, you’ll need to take another pill with just methyldopa.
Child dosage (ages 0–17 years)

This medicine hasn’t been studied in children and shouldn’t be used in children under the age of 18 years.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects.

Your doctor may start you on a lowered dose or a different medication schedule. This can help keep levels of this drug from building up too much in your body.

Warnings

If your doctor increases your dose, start taking your new dose in the evening. This way, you won’t feel as much of the sedation that can happen with dose increases.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Board

Methyldopa/hydrochlorothiazide comes with serious risks if you don't take it as prescribed.

If you don't take it at all

Your blood pressure may get worse. This will raise your chance of a heart attack or stroke.

If you stop taking It suddenly

Don’t stop taking methyldopa/hydrochlorothiazide without talking to your doctor. Stopping the drug suddenly can cause your blood pressure to spike. This may increase your chance for a heart attack or stroke.

If you don't take it on schedule

Your blood pressure may not improve and may get worse. You may have a higher chance of a heart attack or stroke.

If you take too much

Taking too much methyldopa/hydrochlorothiazide can cause severe side effects. These include excessive fatigue, a slow heart rate (bradycardia), dizziness, lightheadedness, diarrhea, constipation, stomach pain, and vomiting. 

Call your doctor right away if you think that you’ve taken too much methyldopa/hydrochlorothiazide.

What to do if you miss a dose

If you forget to take your dose, take it as soon as you remember. If it’s just a few hours until the time for your next dose, then wait and only take one dose at that time.

Never try to catch up by taking two doses at once. This could cause toxic side effects.

How to tell if the drug is working

You can tell methyldopa/hydrochlorothiazide is working because your blood pressure should be better controlled.

Methyldopa/hydrochlorothiazide is used for long-term treatment of high blood pressure.

Important considerations for taking methyldopa/hydrochlorothiazide
take with or without food You can take this drug with or without food
timing Take this drug at the same time each day
do not crush Don't crush or cut the tablet
storage Store this drug carefully See Details
refillable Prescription is refillable
travel Travel See Details
self-management Self-management See Details
clinical monitoring Clinical monitoring See Details
not usually stocked Not every pharmacy stocks this drug. When filling your prescription, make sure to call ahead.
hidden costs Hidden costs See Details
prior authorization Insurance See Details

Store this drug carefully

  • Store methyldopa/hydrochlorothiazide at room temperature between 68ºF (20ºC) and 77°F (25°C).
  • Don’t freeze this drug.
  • Keep it away from light and high temperature.
  • Keep your drugs away from areas where they could get wet, such as bathrooms. Store this drug away from moisture and damp locations.

Travel

When traveling with your medication:

  • Always carry your medication with you, such as in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Self-management

You may need to check your blood pressure at home. You may need to buy your own blood pressure monitoring machine. These are available at most pharmacies. You should keep a log with the date, time of day, and your blood pressure readings. Bring this diary with you to your doctor appointments.

Clinical monitoring

While being treated with methyldopa/hydrochlorothiazide, your doctor may check your:

  • liver function
  • kidney function
  • blood cell counts
  • blood pressure
  • electrolytes

Hidden costs

You may need to purchase a blood pressure monitor to check your blood pressure at home. These can be purchased at your pharmacy.

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.

What does the pill look like?

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on September 29, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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