Last update July 25, 2022

Methyldopa

Very Low Risk

Safe. Compatible. Minimal risk for breastfeeding and infant.

Centrally acting antihypertensive used in the treatment of hypertension. Oral or intravenous administration two to three times a day.

It is excreted into breast milk in non-significant amount (White 1985, Hoskins 1982, Jones 1978) without side-effects observed in breastfed infants from mothers who were on this medication. (White 1985, Hauser 1985, Jones 1978)

Plasma levels in those infants were undetectable or very low. (White 1985, Hauser 1985)

Methyldopa reduces levels of dopamine, noradrenaline, adrenaline, and serotonin. Prolactin level may be increased with the appearance of galactorrhea (Anderson 2018, Arce 1981, Turkington 1972). Such increase of Prolactin level will not affect breastfeeding ability of a mother who has an established lactation.

Methyldopa is associated with increased risk of postnatal depression. (Dennis 2012)

Several medical societies and expert authors consider the use of this medication to be safe during breastfeeding (Hale, LactMed, Anderson 2018, Malachias 2016, Serrano 2015, Briggs 2015, Dennis 2012, Ghanem 2008, Beardmore 2002). The American Academy of Pediatrics rates is as compatible with breastfeeding. (AAP 2001). List of WHO essential medicines: compatible with breastfeeding. (WHO 2002)

Alternatives

We do not have alternatives for Methyldopa since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Methyldopa is also known as


Methyldopa in other languages or writings:

Tradenames

Main tradenames from several countries containing Methyldopa in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 60 %
Molecular weight 211 daltons
Protein Binding 12 %
Tmax 6 hours
1.5 hours
M/P ratio 0.3 -
Theoretical Dose 0.17 mg/Kg/d
Relative Dose 2.1 %
Ped.Relat.Dose 1.6 %

References

  1. Hale TW. Medications & Mothers' Milk. 1991- . Springer Publishing Company. Available from https://www.halesmeds.com Consulted on March 17, 2022 Full text (link to original source)
  2. LactMed. Drugs and Lactation Database (LactMed). Internet. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/ 2006 - Consulted on March 15, 2022 Full text (link to original source)
  3. Anderson PO. Treating Hypertension During Breastfeeding. Breastfeed Med. 2018 Abstract
  4. Malachias MV, Figueiredo CE, Sass N, Antonello IC, Torloni MR, Bortolotto MRF L. 7th Brazilian Guideline of Arterial Hypertension: Chapter 9 - Arterial Hypertension in pregnancy Arq Bras Cardiol. 2016 Abstract Full text (link to original source) Full text (in our servers)
  5. Serrano Aguayo P, García de Quirós Muñoz JM, Bretón Lesmes I, Cózar León MV. Tratamiento de enfermedades endocrinológicas durante la lactancia. [Endocrinologic diseases management during breastfeeding.] Med Clin (Barc). 2015 Jan 20;144(2):73-9. Abstract
  6. Briggs GG, Freeman RK, Towers CV, Forinash AB. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. Wolters Kluwer Health. Tenth edition (acces on line) 2015
  7. Dennis AT. Management of pre-eclampsia: issues for anaesthetists. Anaesthesia. 2012 Sep;67(9):1009-20. Abstract Full text (link to original source) Full text (in our servers)
  8. Ghanem FA, Movahed A. Use of antihypertensive drugs during pregnancy and lactation. Cardiovasc Ther. 2008 Abstract Full text (link to original source) Full text (in our servers)
  9. Beardmore KS, Morris JM, Gallery ED. Excretion of antihypertensive medication into human breast milk: a systematic review. Hypertens Pregnancy. 2002 Abstract Full text (link to original source)
  10. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  11. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Abstract Full text (link to original source) Full text (in our servers)
  12. Hauser GJ, Almog S, Tirosh M, Spirer Z. Effect of alpha-methyldopa excreted in human milk on the breast-fed infant. Helv Paediatr Acta. 1985 Abstract
  13. White WB, Andreoli JW, Cohn RD. Alpha-methyldopa disposition in mothers with hypertension and in their breast-fed infants. Clin Pharmacol Ther. 1985 Abstract
  14. Hoskins JA, Holliday SB. Determination of alpha-methyldopa and methyldopate in human breast milk and plasma by ion-exchange chromatography using electrochemical detection. J Chromatogr. 1982 Jun 11;230(1):162-7. No abstract available. Abstract
  15. Arze RS, Ramos JM, Rashid HU, Kerr DN. Amenorrhoea, galactorrhoea, and hyperprolactinaemia induced by methyldopa. Br Med J (Clin Res Ed). 1981 Jul 18;283(6285):194. No abstract available. Abstract Full text (link to original source)
  16. Jones HM, Cummings AJ. A study of the transfer of alpha-methyldopa to the human foetus and newborn infant. Br J Clin Pharmacol. 1978 Abstract Full text (link to original source) Full text (in our servers)
  17. Turkington RW. Prolactin secretion in patients treated with various drugs: phenothiazines, tricyclic antidepressants, reserpine, and methyldopa. Arch Intern Med. 1972 Abstract

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