Hepatic Injury Caused by L -Alpha-Methyldopa

Abstract

L -alpha-methyldopa (Aldomet)-induced liver disease is a relatively mild and uncommon complication of therapy with this drug. Most commonly it is characterized by a rise in serum alkaline phosphatase, glutamic oxaloacetic transaminase levels, and increased Bromsulphalein retention. Elevation of the serum bilirubin may occur. In its most benign form the condition is usually symptomless, but complaints, such as anorexia, abdominal pain, or pruritus, and signs, such as fever or hepatomegaly, may occur. Histologic changes similar to those of viral hepatitis have been observed. The condition is usually benign and remits on withdrawal of the drug. Progressively more mild exacerbations on readministration of the drug suggest that desensitization may be possible in patients who exhibit hepatic abnormalities. Its low and sporadic incidence is typical of a hypersensitivity reaction. It is suggested that routine liver function tests should be undertaken at intervals during therapy. The occasional occurrence of Aldomet-induced liver disease is no contraindication to the use of this antihypertensive agent.

Electron Paramagnetic Resonance Study on Free Radical Scavenging and/or Generating Activity of Dopamine-4-O-sulfate.

“…And the generation of o-quinone through o-semiquinone radical causes the unfavorable effects of catechol derivatives, such as hepatic injury, 44) cardiotoxicity, 45) and hemolysis. 46) The fact that dopamine-4-O-sulfate is stable for the oxidization under physiological conditions may support the existence of a reservoir 47) of dopamine or a stable detoxicated product of dopamine.…”

Side effects of sympatholytic antihypertensive drugs.

“…A very small percentage of patients receiving methyldopa also develop an idiosyncratic allergic reaction manifested by fever, general malaise, and abnormalities of liver function that in the extreme can result in hepatic necrosis and death. 10 This phenomenon appears to be partially dose related. The fever and abnormalities of liver chemistries can be titrated by increasing or decreasing methyldopa doses.…”

Liver Damage Due to Antihypertensive Drugs

“…The abnormalities mostly consisted in mild elevations of amhotransferases or alkaline phosphatases. Histologic examinations of the liver were reported as normal (Elkington et al 1969, Gillespie et at. 1962, Lauwerset at.…”

“…rash and lymphadenopathy have been uncommon. Two cases have been published that may represent instances of desensitization (Elkington et al 1969, Rodman et al 1976.…”