methyldopa (Rx)

Brand and Other Names:Aldomet
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

injectable solution

  • 50mg/mL

tablet

  • 250mg
  • 500mg

Hypertension

Initial: 250 mg PO q8-12hr for 2 days, increase q2Days PRN

Maintenance: 250-1000 mg/day divided q6-12hr PO, usually no more than 3 g/day

IV (methyldopate): 250-1000 mg infusion over 30-60 minutes q6-8hr PRN; no more than 4 g/day

Hypertensive Crisis

20-40 mg/kg/day divided IV q6hr  

No more than 65 mg/kg/day or 3 g/day (whichever is less)

Renal Impairment

Adjust dosage frequency with renal impairment

CrCl >50 mL/min: q8hr

CrCl 10-50 mL/min: q8-12hr

CrCl <10 mL/min: q12-24hr

Type 1 Diabetes Mellitus (Orphan)

Orphan designation for type 1 diabetes in DQ8 positive patients with residual beta cell function

Sponsor

  • IM Therapeutics LLC; 11001 West 120th Avenue, Suite 400; Broomfield, Colorado 80021

Dosage Forms & Strengths

injectable solution

  • 50mg/mL

tablet

  • 250mg
  • 500mg

Hypertension

Neonate: 2.5-5 mg/kg PO or IV q8hr  

10 mg/kg/day divided q12hr PO, increase q2Days PRN

Hypertensive Crisis

20-40 mg/kg/day IV divided q6hr  

No more than 65 mg/kg/day or 3 g/day (whichever is less)

Adverse CNS effects; may cause bradycardia and orthostatic hypotension; not recommended as routine treatment for hypertension (Beers criteria)

Not drug of choice in elderly because of CNS effects

Monitor renal function; renally excreted; decreased renal function more likely in elderly

Hypertension

Lower initial doses and more gradual adjustments recommended

125 mg qDay or q12hr; may increase by 125 mg-increments q2-3days PRN

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Interactions

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              Serious - Use Alternative (29)

              • aripiprazole

                aripiprazole decreases effects of methyldopa by pharmacodynamic antagonism. Contraindicated.

              • benperidol

                benperidol decreases effects of methyldopa by pharmacodynamic antagonism. Contraindicated.

              • chlorpromazine

                chlorpromazine decreases effects of methyldopa by pharmacodynamic antagonism. Contraindicated.

              • clozapine

                clozapine decreases effects of methyldopa by pharmacodynamic antagonism. Contraindicated.

              • droperidol

                droperidol decreases effects of methyldopa by pharmacodynamic antagonism. Contraindicated.

              • fluphenazine

                fluphenazine decreases effects of methyldopa by pharmacodynamic antagonism. Contraindicated.

              • haloperidol

                haloperidol decreases effects of methyldopa by pharmacodynamic antagonism. Contraindicated.

              • iloperidone

                iloperidone decreases effects of methyldopa by pharmacodynamic antagonism. Contraindicated.

              • iobenguane I 131

                methyldopa will decrease the level or effect of iobenguane I 131 by Other (see comment). Avoid or Use Alternate Drug. Based on the mechanism of action of iobenguane, drugs that reduce catecholamine uptake or that deplete catecholamine stores may interfere with iobenguane uptake into cells, and thus, reduce iobenguane efficacy. Discontinue interfering drugs for at least 5 half-lives before administration of either the dosimetry or an iobenguane dose. Do not administer these drugs until at least 7 days after each iobenguane dose.

              • lofexidine

                lofexidine, methyldopa. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.

              • loxapine

                loxapine decreases effects of methyldopa by pharmacodynamic antagonism. Contraindicated.

              • loxapine inhaled

                loxapine inhaled decreases effects of methyldopa by pharmacodynamic antagonism. Contraindicated.

              • metoclopramide

                metoclopramide decreases levels of methyldopa by inhibition of GI absorption. Applies only to oral form of both agents. Contraindicated.

                metoclopramide decreases levels of methyldopa by pharmacodynamic antagonism. Contraindicated.

              • metoclopramide intranasal

                methyldopa, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.

              • olanzapine

                olanzapine decreases effects of methyldopa by pharmacodynamic antagonism. Contraindicated.

              • paliperidone

                paliperidone decreases effects of methyldopa by pharmacodynamic antagonism. Contraindicated.

              • perphenazine

                perphenazine decreases effects of methyldopa by pharmacodynamic antagonism. Contraindicated.

              • pexidartinib

                methyldopa and pexidartinib both increase inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Pexidartinib can cause hepatotoxicity. Avoid coadministration of pexidartinib with other products know to cause hepatoxicity.

              • pimozide

                pimozide decreases effects of methyldopa by pharmacodynamic antagonism. Contraindicated.

              • pretomanid

                methyldopa, pretomanid. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Pretomanid regimen associated with hepatotoxicity. Avoid alcohol and hepatotoxic agents, including herbal supplements and drugs other than bedaquiline and linezolid.

              • prochlorperazine

                prochlorperazine decreases effects of methyldopa by pharmacodynamic antagonism. Contraindicated.

              • promethazine

                promethazine decreases effects of methyldopa by pharmacodynamic antagonism. Contraindicated.

              • quetiapine

                quetiapine decreases effects of methyldopa by pharmacodynamic antagonism. Contraindicated.

              • risperidone

                risperidone decreases effects of methyldopa by pharmacodynamic antagonism. Contraindicated.

              • thioridazine

                thioridazine decreases effects of methyldopa by pharmacodynamic antagonism. Contraindicated.

              • thiothixene

                thiothixene decreases effects of methyldopa by pharmacodynamic antagonism. Contraindicated.

              • tranylcypromine

                tranylcypromine, methyldopa. Other (see comment). Avoid or Use Alternate Drug. Comment: Tranylcypromine inhibits the hypotensive effects of methyldopa. At least 14 days should elapse between discontinuation of MAOI therapy and initiation of treatment with methyldopa.

              • trifluoperazine

                trifluoperazine decreases effects of methyldopa by pharmacodynamic antagonism. Contraindicated.

              • ziprasidone

                ziprasidone decreases effects of methyldopa by pharmacodynamic antagonism. Contraindicated.

              Monitor Closely (55)

              • apomorphine

                apomorphine and methyldopa both increase dopaminergic effects. Use Caution/Monitor.

              • benzphetamine

                methyldopa increases effects of benzphetamine by unknown mechanism. Use Caution/Monitor.

              • bretylium

                methyldopa, bretylium. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Each drug may cause hypotension.

              • cabergoline

                cabergoline and methyldopa both increase dopaminergic effects. Use Caution/Monitor.

              • carbonyl iron

                carbonyl iron decreases levels of methyldopa by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              • clonidine

                clonidine, methyldopa. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Sympatholytic action may worsen sinus node dysfunction and atrioventricular (AV) block.

              • daridorexant

                methyldopa and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

              • dexfenfluramine

                methyldopa increases effects of dexfenfluramine by unknown mechanism. Use Caution/Monitor.

              • dexmethylphenidate

                methyldopa increases effects of dexmethylphenidate by unknown mechanism. Use Caution/Monitor.

              • dextroamphetamine

                methyldopa increases effects of dextroamphetamine by unknown mechanism. Use Caution/Monitor.

              • diethylpropion

                methyldopa increases effects of diethylpropion by unknown mechanism. Use Caution/Monitor.

              • difelikefalin

                difelikefalin and methyldopa both increase sedation. Use Caution/Monitor.

              • dobutamine

                methyldopa increases effects of dobutamine by unknown mechanism. Use Caution/Monitor.

              • dopamine

                dopamine and methyldopa both increase dopaminergic effects. Use Caution/Monitor.

                methyldopa increases effects of dopamine by unknown mechanism. Use Caution/Monitor.

              • entacapone

                entacapone will increase the level or effect of methyldopa by decreasing metabolism. Use Caution/Monitor. Entacapone is a COMT inhibitor. Caution if coadministered with drugs metabolized by COMT. If coadministered, monitor for changes in heart rate, heart rhythm, and blood pressure.

              • ephedrine

                methyldopa increases effects of ephedrine by unknown mechanism. Use Caution/Monitor.

              • epinephrine

                methyldopa increases effects of epinephrine by unknown mechanism. Use Caution/Monitor.

              • fenfluramine

                methyldopa increases effects of fenfluramine by unknown mechanism. Use Caution/Monitor.

              • ferric maltol

                ferric maltol decreases levels of methyldopa by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              • ferrous fumarate

                ferrous fumarate decreases levels of methyldopa by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              • ferrous gluconate

                ferrous gluconate decreases levels of methyldopa by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              • ferrous sulfate

                ferrous sulfate decreases levels of methyldopa by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              • iron dextran complex

                iron dextran complex decreases levels of methyldopa by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              • iron sucrose

                iron sucrose decreases levels of methyldopa by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              • isoproterenol

                methyldopa increases effects of isoproterenol by unknown mechanism. Use Caution/Monitor.

              • levodopa

                methyldopa, levodopa. pharmacodynamic synergism. Use Caution/Monitor. Risk of additive hypotensive effects, and risk of toxic CNS effects such as psychosis.

              • lisdexamfetamine

                methyldopa increases effects of lisdexamfetamine by unknown mechanism. Use Caution/Monitor.

              • lisuride

                lisuride and methyldopa both increase dopaminergic effects. Use Caution/Monitor.

              • lurasidone

                lurasidone increases effects of methyldopa by Other (see comment). Use Caution/Monitor. Comment: Potential for increased risk of hypotension with concurrent use. Monitor blood pressure and adjust dose of antihypertensive agent as needed.

              • methamphetamine

                methyldopa increases effects of methamphetamine by unknown mechanism. Use Caution/Monitor.

              • methylenedioxymethamphetamine

                methyldopa increases effects of methylenedioxymethamphetamine by unknown mechanism. Use Caution/Monitor.

              • methylphenidate

                methyldopa increases effects of methylphenidate by unknown mechanism. Use Caution/Monitor.

              • midazolam intranasal

                midazolam intranasal, methyldopa. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.

              • midodrine

                methyldopa increases effects of midodrine by unknown mechanism. Use Caution/Monitor.

              • mipomersen

                mipomersen, methyldopa. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Both drugs have potential to increase hepatic enzymes; monitor LFTs.

              • nadolol

                nadolol, methyldopa. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Non selective beta blocker administration during withdrawal from methyldopa may result in rebound hypertension.

              • norepinephrine

                methyldopa increases effects of norepinephrine by unknown mechanism. Use Caution/Monitor.

              • opicapone

                opicapone will increase the level or effect of methyldopa by decreasing metabolism. Use Caution/Monitor. Opicapone is a COMT inhibitor. Caution if coadministered with drugs metabolized by COMT. If coadministered, monitor for changes in heart rate, heart rhythm, and blood pressure.

              • phendimetrazine

                methyldopa increases effects of phendimetrazine by unknown mechanism. Use Caution/Monitor.

              • phentermine

                methyldopa increases effects of phentermine by unknown mechanism. Use Caution/Monitor.

              • phenylephrine

                methyldopa increases effects of phenylephrine by unknown mechanism. Use Caution/Monitor.

              • phenylephrine PO

                methyldopa increases effects of phenylephrine PO by unknown mechanism. Use Caution/Monitor.

              • pindolol

                pindolol, methyldopa. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Non selective beta blocker administration during withdrawal from methyldopa may result in rebound hypertension.

              • polysaccharide iron

                polysaccharide iron decreases levels of methyldopa by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              • pramipexole

                methyldopa and pramipexole both increase dopaminergic effects. Use Caution/Monitor.

              • propranolol

                propranolol, methyldopa. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Non selective beta blocker administration during withdrawal from methyldopa may result in rebound hypertension.

              • propylhexedrine

                methyldopa increases effects of propylhexedrine by unknown mechanism. Use Caution/Monitor.

              • pseudoephedrine

                methyldopa increases effects of pseudoephedrine by unknown mechanism. Use Caution/Monitor.

              • ropinirole

                methyldopa and ropinirole both increase dopaminergic effects. Use Caution/Monitor.

              • rose hips

                rose hips decreases levels of methyldopa by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              • serdexmethylphenidate/dexmethylphenidate

                methyldopa increases effects of serdexmethylphenidate/dexmethylphenidate by unknown mechanism. Use Caution/Monitor.

              • timolol

                timolol, methyldopa. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Non selective beta blocker administration during withdrawal from methyldopa may result in rebound hypertension.

              • tolcapone

                tolcapone will increase the level or effect of methyldopa by decreasing metabolism. Use Caution/Monitor. Tolcapone is a COMT inhibitor. Caution if coadministered with drugs metabolized by COMT. If coadministered, monitor for changes in heart rate, heart rhythm, and blood pressure.

              • xylometazoline

                methyldopa increases effects of xylometazoline by unknown mechanism. Use Caution/Monitor.

              • yohimbine

                methyldopa increases effects of yohimbine by unknown mechanism. Use Caution/Monitor.

              Minor (1)

              • lithium

                methyldopa increases toxicity of lithium by unknown mechanism. Minor/Significance Unknown.

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              Adverse Effects

              Frequency Not Defined

              Angina

              Bradycardia

              Orthostatic hypotension

              Depression

              Dizziness

              Lethargy

              Sedation

              Rash

              Gynecomastia

              Impotence

              Dry mouth

              Nausea

              Vomiting

              Hemolytic anemia

              Thrombocytopenia

              Liver toxicity

              Arthralgia

              Autoimmune disease

              Lupus-like syndrome

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              Warnings

              Contraindications

              Active liver disease, liver disorders associated with previous methyldopa treatment

              Hypersensitivity to methyldopa or other ingredients (eg, sulfites)

              Pheochromocytoma

              Concomitant MAOIs

              Cautions

              CHF, dialysis patients (increased risk of hypertension following procedure), edema, hemolytic anemia, hypotension, severe bilateral CVD, history of liver disease

              Avoid abrupt withdrawal

              Risk of decreased libido and impotence in men

              May impair ability to perform hazardous tasks

              Tolerance develops on prolonged treatment, especially if no concurrent diuretic (methyldopa causes Na and water retention)

              Interferes with some lab tests

              IM/SC NOT recommended due to erratic absorption

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              Pregnancy & Lactation

              Pregnancy Category: B

              Lactation: distributed in breast milk but not in clinically significant amounts; compatible w/ breastfeeding

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              Methyldopa may lower blood pressure by stimulating central inhibitory alpha-adrenergic receptors, false neurotransmission, and/or reduction of plasma renin activity.

              Pharmacokinetics

              Onset: PO 3-6 hr; IV 4-6 hr

              Duration: PO 12-24 hr; IV 10-16 hr

              Absorption: 50%

              Protein Bound: Minimal

              Vd: 0.6 L/kg

              Metabolism: Liver

              Metabolite: Methyldopa-o-sulfate (may be active), 3-methoxy-methyldopa (inactive)

              Excretion: Urine (70%), feces (30-50%)

              Dialyzable: Yes (HD; removes 60%; PD removes lesser amount)

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              Administration

              IV Incompatibilities

              Additive: ampho B, methohexital

              IV Compatibilities

              Solution: D5W, NS, Ringer's, D5/NS

              Additive: aminophylline, ascorbic acid, chloramphenicol, diphenhydramine, heparin, MgSO4, netilmicin, KCl, promazine, NaHCO3, succinylcholine, verapamil, vitamin B/C

              Y-site: esmolol, heparin, meperidine, morphine SO4, theophylline

              IV Preparation

              Dilute required dose in 100 mL D5W

              IV Administration

              Slow infusion over 30-60 min

              Oral Administration

              May increase dose/give higher amount HS to avoid adverse events during waking hours

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              methyldopa oral
              -
              500 mg tablet
              methyldopa oral
              -
              250 mg tablet
              methyldopa oral
              -
              250 mg tablet
              methyldopa oral
              -
              500 mg tablet

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Patient Education
              methyldopa oral

              METHYLDOPA - ORAL

              (METH-il-DOE-pa)

              COMMON BRAND NAME(S): Aldomet

              USES: This medication is used alone or with other medications to treat high blood pressure (hypertension). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Methyldopa works by relaxing blood vessels so blood can flow more easily.

              HOW TO USE: Take this medication by mouth with or without food as directed by your doctor, usually 2 to 4 times daily. Start this medication or any new dose increase in the evening to decrease the risk of side effects. Also, if the doses of this medication are not equal, take the larger dose at bedtime.The dosage is based on your medical condition and response to treatment.Use this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day. Keep taking this medication even if you feel well. Most people with high blood pressure do not feel sick.When used for a long time, this medication may not work as well and may require different dosing or an additional medication. Talk with your doctor if this medication stops working well (such as your blood pressure readings remain high or increase).

              SIDE EFFECTS: Dizziness, lightheadedness, drowsiness, headache, stuffy nose, and weakness may occur as your body adjusts to the medication. If any of these effects last or get worse, tell your doctor or pharmacist promptly.To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: fainting, muscle spasms/uncontrolled muscle movements, missed/stopped periods, decreased sexual desire/ability, increased breast size (in men), mental/mood changes (such as depression), symptoms of heart failure (such as shortness of breath, swelling ankles/feet, unusual tiredness, unusual/sudden weight gain).Methyldopa has rarely caused very serious (rarely fatal) liver disease or low red blood cell count (anemia). Tell your doctor right away if you develop any symptoms of liver disease or anemia, including: nausea/vomiting that doesn't stop, unusual tiredness, fast heartbeat, unexplained fever, dark urine, severe stomach/abdominal pain, yellowing eyes/skin.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before taking methyldopa, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease (such as hepatitis, cirrhosis), low red blood cell count (anemia), heart failure, pheochromocytoma, a certain genetic condition (glucose-6-phosphate dehydrogenase deficiency).This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the side effects of this medication, especially dizziness (more likely when standing up), fainting, or depression. Dizziness and fainting can increase the risk of falling.Tell your doctor if you are pregnant before using this medication.This medication passes into breast milk but is unlikely to harm a nursing infant. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: iron products (such as ferrous sulfate, ferrous gluconate), lithium.Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before treatment with this medication. Ask your doctor when to start or stop taking this medication.Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, marijuana (cannabis), antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and opioid pain relievers (such as codeine).Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.Some products have ingredients that could raise your blood pressure. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).This medication may interfere with certain laboratory tests (including urine catecholamine test), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe drowsiness/dizziness.

              NOTES: Do not share this medication with others.Laboratory and/or medical tests (such as hematocrit/hemoglobin, complete blood count, Coombs test, liver function) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.Lifestyle changes such as stress reduction programs, exercise, and dietary changes may increase the effectiveness of this medicine. Talk to your doctor or pharmacist about lifestyle changes that might benefit you.Check your blood pressure regularly while taking this medication. Learn how to monitor your own blood pressure at home, and share the results with your doctor.

              MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

              STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

              Information last revised December 2021. Copyright(c) 2022 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Formulary

              FormularyPatient Discounts

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              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.