Domepa 250mg Domesco medicine for hypertension (10 blisters x 10 tablets)

Dosage form Box of 10 blisters x 10 tablets
Specifications Methyldopa

Ingredient

Composition information	Content
Methyldopa	250mg

Uses

Indications

Domepa 250mg drug is indicated in the following cases:

Treatment of hypertension. Especially hypertension in pregnant people.

Pharmacy

Methyldopa is a structural antihypertensive drug related to catecholamine and their precursors. Although the mechanism of action also needs to be verified, the anti -hypertension effect of methyldopa is probably because the drug is metabolized in the central nervous system to Alpha Methyl Norepinephrin, this substance stimulates alpha adrenergic receptors leading to sensitive hypertension and reducing blood pressure. Therefore, Methyldopa is considered a sympathetic drug that has a central impact.

Methyldopa also reduces the lyin activity in plasma and contributes to the hypotension effect of the drug. Methyldopa inhibits carboxyl reduction of dihydroxyphenylalanin (DOPA) (is the precursor of norepinephrin) and 5 - hydroxytryptophan (the precursor of serotonin).

Although the main hypotension effect of the drug is not due to decarboxylase inhibition, it is not possible to eliminate the contribution of peripheral mechanism. Methyldopa has been shown to reduce the concentration of serotonin, dopamine, norepinephrin and epinephrin in tissues.

Methyldopa lowers blood pressure both in a standing position and a lying position. The drug does not directly affect the kidney and heart function. The cardiac supply is often maintained, no heart frequency.

In some cases, the heart rate may slow down. The supply of kidney, glomerular filtration, or filter fraction is usually not affected, so the effect of reducing blood pressure can be maintained even in patients with renal impairment. Rarely have symptoms of posture hypotension, hypotension during activity and blood pressure change for days.

Methyldopa can be used in combination with other hypotension , especially thiazids, including combinations of thiazid and amilorid. Methyldopa can also be combined with beta blockers.

pharmacokinetics

Because the effects of methyldopa through alpha - methyl - norepinephrin metabolites, the plasma concentration of methyldopa has little validity value of the drug. The absorption of methyldopa is incomplete.

Average bioavailability only reaches 25% of the dose and changes a lot among patients. The maximum concentration in the plasma of the drug is achieved within 2-4 hours after drinking, the anti -hypertension effect is maximum after 4-6 hours. The semi -discharging time in the plasma of the drug is 1-2 hours for people with normal kidney function and increases when the kidney function decreases. The distribution card of the drug is 0.6 liters/kg.

About 70% of the dose is excreted through the kidneys, of which 60% are free methyldopa, the rest is metabolites in the form of a conjugate form.

Before taking Domepa 250mg Domesco medicine for hypertension (10 blisters x 10 tablets)

How to use

Oral drugs.

Dosage

Adults:

The starting dose is 250mg, 2-3 times/day, in the first 48 hours. This dose is then adjusted depending on the response of each patient. To minimize sedative effects, it is advisable to start increasing the dose in the evening. The maximum daily dose is recommended as 3G.

Methyldopa is excreted in large quantities through the kidneys and people with renal impairment can respond to a smaller dose.

Elderly:

initial dose 125mg, 2 times daily, the dose may increase gradually. The maximum dose of 2g/day. Fainting in the elderly may be related to an increase in drug sensitivity or atherosclerosis. This can be avoided by lower doses.

Children:

The starting dose is 10mg/kg body weight/day, divided into 2-4 times, maximum 65mg/kg or 3g/day.

What to do when overdose? When taken medication, you can wash your stomach or cause vomiting. If the drug has been absorbed, it can be transmitted to increase the elimination of the drug through the urine. Pay special attention to the heart frequency, blood flow, electrolyte balance, intestinal paralysis and brain activity. Dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

When using Domepa 250mg, you may experience unwanted effects (ADR).

When treated with methyldopa lasts long, 10-20% of patients have positive Coombs reaction. In this case, in a rare number of circumstances that can be combined with hemolytic anemia and then it can lead to deadly complications. The most common is sedative effect, at least 30%; Dizziness, 18% of patients take medicine and dry mouth 10% of the drug users. Headache when treated, after all (10%).

Common, ADR> 1/100

Body: headache , dizziness , fever.

Respiratory: Nasal congestion.

Body: weakness .

Blood: Bone marrow failure, leukopenia, granulocytosis, platelets, Anemia hemolytic, huge red blood cell anemia. Seed Parkinson . No swelling of joints, muscle pain.

Instructions on how to handle ADR

If hemolytic anemia occurs with positive Coombs (this reaction usually occurs after 6 - 12 months of treatment), the cause may be due to methyldopa, in this case, the drug should be stopped. The lowest incidence if the daily dose is equal to or less than 1 g. Usually the symptoms of anemia decrease rapidly. If hemolytic anemia is associated with methyldopa, it is not advisable to continue taking the drug.

Hemolytic anemia occasionally occurs not related to positive or negative coombs. This case occurs in people with glucose deficiency - 6 - phosphate dehydrogenase, with a higher rate in residential areas exposed to malaria compared to residential areas not exposed to malaria.

Sedative effects can occur at the beginning of the drug or when increasing the dose, but this unwanted effect will end up when performing maintenance treatment.

When using methyldopa, the main effect is mainly fever due to drugs. The fever occasionally accompanied by eosin leukemia and/or liver dysfunction on testing, fever that may occur in stages, but usually only occurs in the first 3 weeks of the treatment. Jaundice may occur but also usually in the first 2 or 3 months of taking the drug.

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Before using Domepa 250mg, you need to read the instructions carefully and refer to the information below.

Contraindicated

Domepa 250mg drug is contraindicated in the following cases:

Hypersensitivity to any ingredients of the drug.

Precautions when using

History of liver disease or liver dysfunction in advance.

severe kidney failure. Do liver test for the first 6-12 weeks of treatment or when the patient has a fever but for unknown reasons.

The ability to drive and operate machinery

methyldopa can cause drowsiness, should not be used when driving or operating the machine.

Pregnancy

Unknown about drug risks. Methyldopa can be used for hypertension caused by pregnancy. The drug does not cause teratogenicity, but among babies born from mothers who have been treated with drugs during pregnancy, sometimes there is a period of hypotension.

Breastfeeding period

methyldopa is excreted into breast milk, which can cause risks for children with treatment dose commonly used for nursing mothers. So the drug should not be used for nursing mothers.

Drug interaction

should be cautious when using methyldopa with the following drugs:

Other hypertension drugs: can increase the effect of lowering blood pressure, increased adverse reactions or therapeutic reactions. level. Blood and causing difficulty in control of blood pressure.

Storage

Leave a cool place, avoid light, temperature below 30⁰C.

To be out of reach of children.

Other drugs

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