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Methyldopa for Treatment of Hypertension FREE

Sheldon G. Sheps, MD; Alexander Schirger, MD; Philip J. Osmundson, MD; John F. Fairbairn, II, MD
[+] Author Affiliations

Rochester, Minn.

From the Mayo Clinic and Mayo Foundation.


JAMA. 1963;184(8):616-621. doi:10.1001/jama.1963.03700210050008
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Methyldopa is an enzyme inhibitor and an effective antihypertensive agent in man. In a study of 33 hypertensive patients, mean blood pressure levels were reduced more than 10% for the sitting position in 61%, and for the standing position in 71%. There were indications of liver damage in seven patients, probable drug fever in one, fluid retention in four, and aggravation of angina pectoris in two. The best indication for the use of methyldopa appeared to be renal insufficiency in hypertensive patients. The authors hesitate to advocate other than investigational use of this drug until the significance of its effects on the heart and liver are more clearly established.

REFERENCES

Sheps, S.G., et al: Effect of Methyldopa on Metabolism of Catecholamines and Tryptophan in Two Cases of Metastatic Pheochromocytoma, unpublished data.
Karmen, A.:  Note on Spectrophotometric Assay of Glutamic-Oxaloacetic Transaminase in Human Blood Serum , J Clin Invest 34:131 ( (Jan 1) ) 1955;.
Cannon, P.J., et al:  Effect of α-Methyl DOPA in Severe and Malignant Hypertension , JAMA 179:673 ( (March 3) ) 1962;.
Leonard, J.W.; Gifford, R.W., Jr.; and Humphrey, D.C.:  Febrile Reactions to L,-α-Methyldopa: Report of Three Cases , Cleveland Clin Quart 29:144 ( (July) ) 1962;.
Gillespie, L., Jr.:  Clinical Pharmacology of Newer Antihypertensive Agents Monoamine Oxide and Decarboxylase Inhibitors, Bretylium Tosylate, and Guanethidine , Ann NY Acad Sci 88:1011 ( (Oct 11) ) 1960;.
Irvine, R.O.H.; O'Brien, K.P.; and North, J.D.K.:  α-Methyl-Dopa in Treatment of Hypertension , Lancet 1:300 ( (Feb 10) ) 1962;.
Stone, CA., et al:  Effect of α-Methyl-3, 4-dihydroxyphenylalanine (Methyldopa) Reserpine and Related Agents on Some Vascular Responses in Dog , J Pharmacol Exp Ther 136:80 ( (April) ) 1962;.
Dollery, C.T., and Harington, M.:  Methyldopa in Hypertension: Clinical and Pharmacological Studies , Lancet 1:759 ( (April 14) ) 1962;.
Bayliss, R.I.S., and Harvey-Smith, E.A.:  Methyldopa in Treatment of Hypertension , Lancet 1:763 ( (April 14) ) 1962;.
Hallwright, G.P.:  Agranulocytosis Caused by Methyl Dopa (Aldomet) , New Zeal Med J 60:567 ( (Dec) ) 1961;.
Kirkendall, W.M., and Wilson, W.R.:  Pharmacodynamics and Clinical Use of Guanethidine, Bretylium, and Methyldopa , Amer J Cardiol 9:107 ( (Jan) ) 1962;.
Oates, J.A., et al:  Decarboxylase Inhibition and Blood Pressure Reduction by α-Methyl-3, 4-dihydroxy-DL-phenylalanine, Abstract , Science 131:1890 ( (June 24) ) 1960;.
Stone, C., et al: " Pharmacology of Decarboxylase Inhibitors ," in Brest, A., and Moyer, J.: Hypertension: Recent Advances , Philadelphia: Lea & Febiger, 1961;, pp 417-423.
Hess, S.M., et al:  Effects of α-Methyl-dopa and α-Methyl-metatyrosine on Metabolism of Norepinephrine and Serotonin in Vivo , J Pharmacol Exp Ther 134:129 ( (July) ) 1961;.
Goldberg, L.I.; DaCosta, F.M.; and Ozaki, M.:  Actions of Decarboxylase Inhibitor, α-Methyl-3, 4-dihydroxyphenylalanine, in Dog , Nature 188:502 ( (Nov 5) ) 1960;.
Onesti, G., et al:  Pharmacodynamic Effects and Clinical Use of Alpha Methyldopa in Treatment of Essential Hypertension , Amer J Cardiol 9:863 ( (June) ) 1962;.
Wilson, W.R.; Fisher, F.D.; and Kirkendall, W.M.:  Acute Hemodynamic Effects of α-Methyl-dopa in Man, Abstract , J Clin Invest 40:1089 ( (June) ) 1961;.
Sannerstedt, R.; Varnauskas, E.; and Werko, L.:  Hemodynamic Effects of Methyldopa (Aldomet) at Rest and During Exercise in Patients with Arterial Hypertension , Acta Med Scand 171:75, 1962;.
Faulk, W.T., and Fleisher, G.A.:  Effects of Opiates on Activity of Serum Transaminase , Proc Mayo Clin 32:405 ( (Aug 7) ) 1957;.

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Sheps, S.G., et al: Effect of Methyldopa on Metabolism of Catecholamines and Tryptophan in Two Cases of Metastatic Pheochromocytoma, unpublished data.
Karmen, A.:  Note on Spectrophotometric Assay of Glutamic-Oxaloacetic Transaminase in Human Blood Serum , J Clin Invest 34:131 ( (Jan 1) ) 1955;.
Cannon, P.J., et al:  Effect of α-Methyl DOPA in Severe and Malignant Hypertension , JAMA 179:673 ( (March 3) ) 1962;.
Leonard, J.W.; Gifford, R.W., Jr.; and Humphrey, D.C.:  Febrile Reactions to L,-α-Methyldopa: Report of Three Cases , Cleveland Clin Quart 29:144 ( (July) ) 1962;.
Gillespie, L., Jr.:  Clinical Pharmacology of Newer Antihypertensive Agents Monoamine Oxide and Decarboxylase Inhibitors, Bretylium Tosylate, and Guanethidine , Ann NY Acad Sci 88:1011 ( (Oct 11) ) 1960;.
Irvine, R.O.H.; O'Brien, K.P.; and North, J.D.K.:  α-Methyl-Dopa in Treatment of Hypertension , Lancet 1:300 ( (Feb 10) ) 1962;.
Stone, CA., et al:  Effect of α-Methyl-3, 4-dihydroxyphenylalanine (Methyldopa) Reserpine and Related Agents on Some Vascular Responses in Dog , J Pharmacol Exp Ther 136:80 ( (April) ) 1962;.
Dollery, C.T., and Harington, M.:  Methyldopa in Hypertension: Clinical and Pharmacological Studies , Lancet 1:759 ( (April 14) ) 1962;.
Bayliss, R.I.S., and Harvey-Smith, E.A.:  Methyldopa in Treatment of Hypertension , Lancet 1:763 ( (April 14) ) 1962;.
Hallwright, G.P.:  Agranulocytosis Caused by Methyl Dopa (Aldomet) , New Zeal Med J 60:567 ( (Dec) ) 1961;.
Kirkendall, W.M., and Wilson, W.R.:  Pharmacodynamics and Clinical Use of Guanethidine, Bretylium, and Methyldopa , Amer J Cardiol 9:107 ( (Jan) ) 1962;.
Oates, J.A., et al:  Decarboxylase Inhibition and Blood Pressure Reduction by α-Methyl-3, 4-dihydroxy-DL-phenylalanine, Abstract , Science 131:1890 ( (June 24) ) 1960;.
Stone, C., et al: " Pharmacology of Decarboxylase Inhibitors ," in Brest, A., and Moyer, J.: Hypertension: Recent Advances , Philadelphia: Lea & Febiger, 1961;, pp 417-423.
Hess, S.M., et al:  Effects of α-Methyl-dopa and α-Methyl-metatyrosine on Metabolism of Norepinephrine and Serotonin in Vivo , J Pharmacol Exp Ther 134:129 ( (July) ) 1961;.
Goldberg, L.I.; DaCosta, F.M.; and Ozaki, M.:  Actions of Decarboxylase Inhibitor, α-Methyl-3, 4-dihydroxyphenylalanine, in Dog , Nature 188:502 ( (Nov 5) ) 1960;.
Onesti, G., et al:  Pharmacodynamic Effects and Clinical Use of Alpha Methyldopa in Treatment of Essential Hypertension , Amer J Cardiol 9:863 ( (June) ) 1962;.
Wilson, W.R.; Fisher, F.D.; and Kirkendall, W.M.:  Acute Hemodynamic Effects of α-Methyl-dopa in Man, Abstract , J Clin Invest 40:1089 ( (June) ) 1961;.
Sannerstedt, R.; Varnauskas, E.; and Werko, L.:  Hemodynamic Effects of Methyldopa (Aldomet) at Rest and During Exercise in Patients with Arterial Hypertension , Acta Med Scand 171:75, 1962;.
Faulk, W.T., and Fleisher, G.A.:  Effects of Opiates on Activity of Serum Transaminase , Proc Mayo Clin 32:405 ( (Aug 7) ) 1957;.
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