Antihypertensive efficacy of a single bedtime dose of methyldopa

Wright, J. Michael; McLeod, Peter; McCullough, W.

doi:10.1002/cpt1976206733

Cited by 16 publications

(5 citation statements)

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“…The degree of fluctuation in blood pressure observed would not have been predicted from earlier studies comparing once daily bedtime doses of methyldopa with multiple daily dose therapy (Wright et al, 1976;Pipkin et al, 1980). Two major disadvantages are associated with studies of that type.…”

Section: Discussionmentioning

confidence: 58%

“…However, the necessity of this inconvenient dosing regimen has been brought into question. The administration of methyldopa once daily at night is now being recommended (Wright et al, 1976;Pipkin et al, 1980) in an attempt to improve compliance (Haynes et al, 1977), and lessen the side effects of drowsiness during the day.…”

Section: Introductionmentioning

confidence: 99%

“…(2) Single oral doses of methyldopa produced antihypertensive effects which were still noticeable 24 h later (Dollery & Harrington, 1962;Jain etal., 1973). (3) In a doubleblind (Wright et al, 1976) and open (Pipkin et al, 1980) The patients were prescribed a total daily dose of methyldopa which was the nearest multiple of 500 mg to the dosage of methyldopa which they were previously receiving. Those patients who previously received a diuretic as part of their antihypertensive regimen were instructed to take the same dose of diuretic throughout the trial.…”

Section: Introductionmentioning

confidence: 99%

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Duration of effect of single daily dose methyldopa therapy.

Jm¹,

Orozco-Gonzalez²,

Polak³

et al. 1982

Brit J Clinical Pharma

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1 Methyldopa has a short plasma half‐life, but longer duration of antihypertensive effect. A single bedtime dose of methyldopa has been recommended to improve compliance and decrease side effects. 2 This double‐blind crossover study was designed to determine the duration of antihypertensive effect of methyldopa by comparing hourly supine and standing blood pressures, throughout the day during placebo, single morning dose, and single evening dose methyldopa therapy in 10 patients. The major side effects, drowsiness and dry mouth were assessed by visual analogue scale. Exercise blood pressures were measured 6, 12, 18 and 24 h after the dose. 3 The antihypertensive effect of methyldopa peaked after 6‐9 h and declined thereafter with a half‐life of approximately 10 h. Little antihypertensive effect remained 24‐26 h after the dose. The time course of the reduction in blood pressure during exercise and of the major side effects paralleled the antihypertensive effects. 4 The results suggest that the duration of antihypertensive effect of methyldopa is long enough to permit twice daily dosing, but that single daily dosing cannot be recommended for most patients. The study illustrates the importance of knowing the time of the last methyldopa dose when assessing blood pressure measurements in patients taking the drug.

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Section: Discussionmentioning

confidence: 58%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Duration of effect of single daily dose methyldopa therapy.

Jm¹,

Orozco-Gonzalez²,

Polak³

et al. 1982

Brit J Clinical Pharma

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“…Hypokalaemia was also absent from our patient group probably because of the potassium sparing effect of amiloride 16 , 17 . Avoidance of hypokalaemia and hypomagnesaemia are of particular importance in the elderly because of their potential to induce cardiac arrhyt‐mias 18–21 .…”

Section: Discussionmentioning

confidence: 76%

The effect of a single daily low dose of methyldopa and K + sparing diuretic on blood pressure in the elderly

Fidel¹,

Glikberg²

1988

Int J Clinical Practice

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however, consideration should be given to the physiological changes of aging which include reduced pulse pressures secondary to decreased aortic distensibility, a tendency to orthostatic hypotension due to changes in the carotid body and aortic arch, a lower cardiac output, increased peripheral vascular resistance, decreased plasma renin, decreased renal function, decreased hepatic metabolism, lower lean body mass and changes in intestinal function and motility and interference with anti-inflammatory agents

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“…It is well demonstrated that reserpine effectively lowers blood pressure with a single daily dose. Methyldopa 16 and certain beta‐blockers (naldolol and atenolol) 17 can be used once daily also. Propranolol, 18 clonidine 15 and prazosin require a minimum of twice‐daily use.…”

Section: Frequency Of Dosementioning

confidence: 99%

The Use of Reserpine for Elderly Hypertensive Patients

Luxenberg¹,

Feigenbaum²

1983

J American Geriatrics Society

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Antihypertensives are among the most commonly prescribed drugs for the elderly. Several studies have discussed the benefits of stepped-care drug therapy for hypertension in the elderly, and propranolol, methyldopa, and more recently, clonidine and prazosin have been recommended as step-two antihypertensive drugs. Recent articles omit reserpine as an alternative. A case is made for the use of reserpine by comparing factors of special importance to most elderly: cost, side-effects, frequency of dosage, number of tablets, and the effect of omitted doses.

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Antihypertensive efficacy of a single bedtime dose of methyldopa

Cited by 16 publications

References 1 publication

Duration of effect of single daily dose methyldopa therapy.

Duration of effect of single daily dose methyldopa therapy.

The effect of a single daily low dose of methyldopa and K + sparing diuretic on blood pressure in the elderly

The Use of Reserpine for Elderly Hypertensive Patients

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