Dopegyt - application rules for different ages. Dopegyt - application rules for different ages Dopegyt side effects

Date: 04.11.2019

Dopegyt (the active substance of methyldopa) is an antihypertensive agent of central action. It is a prodrug: once in the body, it undergoes metabolic transformation with the formation of alpha-methylnorepinephrine, which, in turn, has an antihypertensive effect through several mechanisms at once. First of all, the drug reduces the tone of the sympathetic nervous system due to the activation of central presynaptic inhibition through alpha receptors. Dopegyt plays the role of a false mediator and replaces endogenous dopamine in the corresponding nerve endings, which also contributes to the development of the antihypertensive effect of the drug. An important property of dopegyt is its ability to reduce the activity of the vasopressor factor renin and, accordingly, reduce the total peripheral vascular resistance. And the last link in the combined antihypertensive mechanism of action of dopegyt is the suppression of the reproduction of norepinephrine, as well as a decrease in the concentration of norepinephrine, adrenaline, dopamine and serotonin in tissues due to the suppression of the activity of dopa decarboxylase. Dopegyt does not directly affect cardiac function, does not reduce the minute volume of blood, does not cause a reflex increase in heart rate, does not suppress glomerular filtration, does not reduce the filtered fraction and does not inhibit renal blood flow. In some cases, under the action of the drug, a decrease in heart rate was noted. Dopegyt effectively reduces arterial pressure when the patient is in the supine and standing position. Rarely causes orthostatic hypotension (a sharp drop in blood pressure with a change in body position). After ingestion of a single dose of dopegyt, the peak of its action develops at 4-6 hours and lasts an average of about 12-24 hours. With regular use of the drug, the maximum decrease in blood pressure is noted for 2-3 days.

After stopping treatment, the blood pressure level returns to normal within the next 1-2 days.

Dopegyt is available in tablets. The drug should be taken before or after a meal. The doctor sets the dosage regimen individually for each patient. By general recommendations treatment with dopegyt begins with a dose of 250 mg 2-3 times a day. Subsequently, based on the result obtained from pharmacotherapy (the degree of reduction in blood pressure), the dose can be either increased or reduced, while observing at least a two-day interval between dose changes. You should be aware that with an increase in the dose of the drug, as well as in the first 2-3 days after the start of the drug course, a sedative effect may develop, therefore it is recommended to increase, first of all, the evening dose of dopegyt. To maintain what has been achieved therapeutic effect take 0.5-2 g of the drug per day for 2-4 doses. The allowable daily maximum is 3 g, but, as a rule, if it is not possible to achieve a tangible result when taking 2 g of dopegyt per day, another antihypertensive drug is additionally included in the medication course. 2-3 months after the start of treatment, dopegyt may develop resistance (tolerance). In such cases, either increase the dose or combine the drug with diuretics. Within two days after the abolition of dopegyt, blood pressure returns to the starting point without the manifestation of the so-called "rebound effect". The drug can be used in patients who have already tried other antihypertensive drugs. medicines, subject to the smooth cancellation of the latter. In such cases, treatment with dopegyt begins with a dose of 500 mg per day. In some cases, in patients taking dopegyt, there is an increase in body weight, edema appears. Data adverse reactions eliminated with diuretics.

Pharmacology

Antihypertensive drug of central action. It is metabolized to form alpha-methylnorepinephrine, which has a hypotensive effect through several mechanisms:

decrease in sympathetic tone by stimulating central inhibitory presynaptic α 2 receptors;
substitution of endogenous dopamine at dopaminergic nerve endings (as a false neurotransmitter);
a decrease in the activity of renin in blood plasma and a decrease in OPSS;
suppression of the synthesis of norepinephrine, a decrease in the concentration of dopamine, serotonin, norepinephrine and adrenaline in tissues due to inhibition of the activity of the dopa decarboxylase enzyme.

Methyldopa has no direct effect on heart function, does not reduce cardiac output, does not cause reflex tachycardia, and also does not reduce the glomerular filtration rate, renal blood flow, filtered fraction. In some cases, the heart rate decreases. Effectively reduces blood pressure both in the supine position and standing. Rarely causes postural hypotension.

After a single oral dose maximum effect develops within 4-6 hours and lasts approximately 12-24 hours. With repeated use of the drug, the maximum decrease in blood pressure is achieved on days 2-3. After discontinuation of therapy, blood pressure returns to baseline within 1-2 days.

Pharmacokinetics

Suction

The absorption of methyldopa from the gastrointestinal tract is approximately 50%. After oral administration, the bioavailability of methyldopa is about 25%. C max in blood plasma is reached in 2-3 hours.

Distribution

Plasma protein binding - less than 20%. Methyldopa crosses the placental barrier and is excreted in breast milk.

Metabolism

The metabolism of methyldopa is intense. Methyldopa is metabolized primarily in the liver. The active metabolite of methyldopa, alpha-methylnorepinephrine, is formed in adrenergic neurons of the central nervous system. There are also some other methyldopa derivatives that are excreted by the kidneys.

breeding

Approximately two-thirds of the absorbed methyldopa is excreted from the body by the kidneys unchanged, as well as in the form of sulfate compounds. The rest of the drug is excreted through the intestines (also unchanged). The elimination of methyldopa is biphasic. With preserved kidney function, T 1/2 of the drug is 1.8 ± 0.2 hours. Active substance completely eliminated from the body within 36 hours. Methyldopa is removed from the body by dialysis. A six-hour hemodialysis session results in the removal of approximately 60% of the absorbed dose, while as a result of a 20-30-hour peritoneal dialysis, approximately 22-39% of the drug is removed.

Pharmacokinetics in special clinical situations

If the function of the nights is impaired, the excretion of methyldopa slows down in proportion to the severity kidney failure. In severe renal failure (without hemodialysis), T 1/2 of the drug increases by approximately 10 times.

Release form

Tablets white or grayish-white, round, flat, chamfered, engraved "DOPEGYT" on one side, odorless or almost odorless.

Excipients: ethylcellulose - 8.8 mg, magnesium stearate - 1 mg, corn starch - 45.7 mg, stearic acid - 3 mg, sodium carboxymethyl starch - 3.5 mg, talc - 6 mg.

50 pcs. - brown glass bottles with a PE cap, with a first opening control and an accordion shock absorber (1) - packs of cardboard.

Dosage

Tablets are taken orally before or after meals. The dosing regimen is set individually.

Adult patients

The recommended initial dose of Dopegyt ® in the first 2 days of therapy is 250 mg 2-3 times / day. Then the dose can be gradually increased or decreased (depending on the degree of reduction in blood pressure). The duration of the intervals between increasing and decreasing the dose of the drug Dopegyt ® should be at least 2 days. Since within 2-3 days after the start of therapy, as well as with a subsequent increase in the dose, an adverse sedative effect of the drug may be observed, it is recommended to first increase the evening dose of the drug.

The standard maintenance dose of Dopegyt ® is 0.5-2 g/day. This dose is divided into 2-4 doses. Maximum daily dose the drug should not exceed 3 g. In cases where, while taking the drug at a dose of 2 g / day, there is an insufficiently effective decrease in the level of blood pressure, it is recommended to combine Dopegyt ® with other antihypertensive drugs. After 2-3 months of therapy, tolerance may develop to methyldopa. Effective reduction blood pressure levels can be achieved by increasing the dose of the drug or the concomitant use of diuretics. 48 hours after discontinuation of Dopegyt ® therapy, blood pressure usually returns to baseline. The "rebound effect" is not observed.

The drug Dopegyt ® can be prescribed to patients who are already receiving therapy with other antihypertensive drugs, subject to the gradual withdrawal of these drugs. In such cases, the initial dose of Dopegyt ® should not exceed 500 mg / day. Dose increases are carried out as needed, at intervals of at least 2 days.

When using the drug Dopegyt ® in addition to previously prescribed antihypertensive therapy, dose adjustment of antihypertensive drugs may be required to ensure a smooth transition.

Elderly patients

For elderly patients, the drug is prescribed in the minimum initial dose, which should not exceed 250 mg / day. If necessary, the dose can be gradually increased. The duration of the intervals between increasing the dose of the drug is at least 2 days. The maximum daily dose of Dopegyt ® should not exceed 2 g.

Elderly patients are more likely to experience syncope. This may be due to increased susceptibility to the drug and severe atherosclerotic vascular disease. The development of syncope can be avoided by reducing the dose of the drug Dopegyt ® .

Children over 3 years old

Kidney dysfunction

< 30 мл/мин/1.73 м 2) - до 12-24 ч.

Overdose

Symptoms: pronounced decrease in blood pressure, dizziness, severe drowsiness, weakness, bradycardia, lethargy, tremor, intestinal atony, constipation, bloating, flatulence, diarrhea, nausea, vomiting.

Treatment: gastric lavage, stimulation of vomiting can reduce the amount of absorbed drug. It is necessary to control heart rate, bcc, water and electrolyte balance, bowel and kidney function, as well as the brain. If necessary, you can enter sympathomimetics (eg, epinephrine). There is no specific antidote.

Interaction

Dopegyt ® cannot be used simultaneously with MAO inhibitors.

Simultaneous use with the following drugs requires special care.

Drugs that reduce the antihypertensive effect of the drug Dopegyt ® : sympathomimetics (increase the pressor effect), tricyclic antidepressants, phenothiazines (at the same time they may have an additive antihypertensive effect), oral iron preparations (they may reduce the bioavailability of methyldopa), NSAIDs, estrogenic drugs .

Drugs that enhance the antihypertensive effect of the drug Dopegit ® : other antihypertensive drugs, beta-blockers (increased antihypertensive effect), levodopa + carbidopa (orthostatic hypotension may develop, in this case, patients after taking the drugs should be in horizontal position within 1-2 hours), general anesthetics, anxiolytic drugs (tranquilizers).

Methyldopa and the following drugs may change each other's effects: lithium (danger of increasing lithium toxicity), levodopa (decrease in antiparkinsonian effect and increased undesirable effect on the central nervous system), ethanol and other drugs that depress the central nervous system (increased depression), anticoagulants (increased anticoagulant effect, risk of bleeding), bromocriptine (possibly an undesirable effect on the concentration of prolactin), haloperidol (perhaps a violation of cognitive functions - disorientation and a confused state of consciousness).

Side effects

At the beginning of therapy with Dopegyt ® , as well as with an increase in the dose of the drug, transient sedative effects may be observed, headache, general weakness and fatigue.

Classification adverse reactions depending on the frequency of occurrence: very often (> 1/10), often (from> 1/100 to<1/10), нечасто (от >1/1000 to<1/100), редко (от >1/10 000 up to< 1/1000), очень редко (<1/10 000), отдельные случаи.

In each of these categories, unwanted effects are presented in descending order of severity.

From the side of the cardiovascular system: very rarely - progression of angina pectoris, myocarditis, pericarditis; isolated cases - congestive heart failure, prolonged hypersensitivity of the carotid sinus, orthostatic hypotension (dose reduction is recommended), peripheral edema, weight gain, sinus bradycardia.

Peripheral edema and weight gain usually regress with diuretic therapy. If swelling increases or signs of heart failure appear, the drug should be discontinued.

From the side of the central nervous system: very rarely - parkinsonism; isolated cases - peripheral facial paralysis (Bell's palsy), decreased intelligence, involuntary choreoathetotic motor activity, symptoms of cerebrovascular insufficiency (possibly as a result of hypotension), mental disorders (including nightmares, usually reversible mild psychosis and depression), headache , sedation (usually transient), general weakness or fatigue, dizziness, paresthesia, decreased libido.

From the respiratory system: some cases - nasal congestion.

From the digestive system: very rarely - pancreatitis; isolated cases - colitis, vomiting, diarrhea, inflammation of the salivary glands, pain or dark staining of the tongue, nausea, constipation, bloating, flatulence, dryness of the oral mucosa, hepatitis, necrotizing hepatitis; cholestasis, jaundice.

On the part of the skin: in some cases - toxic epidermal necrolysis, eczema or a rash resembling lichen.

From the musculoskeletal system: in some cases - mild joint pain with or without swelling, myalgia.

From the endocrine system: some cases - hyperprolactinemia, gynecomastia, galactorrhea, amenorrhea.

On the part of the immune system: some cases - vasculitis, lupus syndrome, drug-induced fever, eosinophilia.

Laboratory indicators: very often - a positive Coombs test; rarely - hemolytic anemia, leukopenia, granulocytopenia, thrombocytopenia; isolated cases - depression of bone marrow function, positive test results for antinuclear antibodies, LE cells and rheumatoid factor, increased activity of hepatic transaminases, increased blood urea concentration.

Other: isolated cases - impotence, violations of ejaculation.

Indications

Arterial hypertension.

Contraindications

acute hepatitis, cirrhosis of the liver;
a history of liver disease (against the background of taking methyldopa);
concomitant therapy with MAO inhibitors;
depression;
hemolytic anemia;
acute myocardial infarction;
pheochromocytoma;
children's age up to 3 years (for this dosage form);
hypersensitivity to the drug.

With caution, the drug should be prescribed for renal failure (dose adjustment is required), diencephalic syndrome, elderly patients and children over the age of 3 years.

Application features

Use during pregnancy and lactation

According to the results of clinical studies after the use of methyldopa in the II and III trimesters of pregnancy, there were no signs of damage to the fetus or newborn. Since there have been no adequate and well-controlled studies in the third trimester of pregnancy, it is recommended to use the drug only after a careful comparison of the expected benefit of therapy for the mother and the potential risk to the fetus.

A study of children born to mothers who took methyldopa after the 26th week of pregnancy did not reveal any undesirable effects of the drug. In pregnant women who took the drug in the third trimester, the condition of the fetus was better than in women who did not take the drug.

Methyldopa is excreted in breast milk, therefore it is recommended to prescribe the drug during lactation only after a careful comparison of the expected benefit to the mother and the potential risk to the child.

Application for violations of liver function

Contraindicated in acute hepatitis, cirrhosis of the liver, patients with a history of liver disease that developed while taking methyldopa.

In patients with a history of liver disease or impaired function, this drug should be administered with extreme caution.

Application for violations of kidney function

Methyldopa is excreted mainly by the kidneys, therefore, in the treatment of patients with impaired renal function, the dose of Dopegyt ® must be reduced. With mild renal failure (glomerular filtration rate - 60-89 ml / min / 1.73 m 2), the interval between doses of the drug is recommended to be increased to 8 hours, with moderate renal failure (glomerular filtration rate - 30-59 ml / min / 1.73 m 2 ) - up to 8-12 hours, and in severe renal failure (glomerular filtration rate -< 30 мл/мин/1.73 м 2) - до 12-24 ч.

Methyldopa is removed from the body during dialysis, so it is recommended to use an additional dose of 250 mg of the drug to prevent an increase in blood pressure after a hemodialysis session.

Use in children

Children over 3 years old

For children, the initial dose of the drug is 10 mg / kg body weight / day. The daily dose is divided into 2-4 doses. If necessary, the dose can be gradually increased until the desired effect is achieved. Between the increase in the dose of the drug, an interval of at least 2 days must be observed. The maximum daily dose of Dopegyt ® is 65 mg/kg of body weight/day, but not more than 3 g/day.

Contraindicated in children under 3 years of age.

special instructions

In rare cases, patients taking methyldopa developed hemolytic anemia. When signs of anemia appear, it is necessary to determine the concentration of hemoglobin and hematocrit. If anemia is confirmed, the degree of hemolysis should be further assessed. In case of development of hemolytic anemia, therapy with Dopegyt ® must be discontinued. After discontinuation of therapy (with or without corticosteroids), remission is usually achieved quickly. However, in rare cases, deaths have been observed. Taking the drug Dopegyt ® is contraindicated in patients with hemolytic anemia that developed during therapy with this drug.

In some patients who have been taking Dopegyt for a long time, a positive Coombs test is determined. According to various researchers, the prevalence of this reaction varies from 10 to 20%. A positive Coombs' test is rarely observed during the first 6 months of therapy. If this phenomenon has not developed during the first 12 months of therapy, then in the future its detection is unlikely. The prevalence of a positive Coombs test is dose-dependent. This phenomenon is least often observed in patients taking the drug at a dose of 1000 mg / day or less. The Coombs test, which is positive while taking methyldopa, becomes negative several weeks or months after cessation of drug therapy. Before starting treatment, as well as at 6 and 12 months of therapy, it is recommended to perform a complete blood count and a direct Coombs test.

Identification of a positive Coombs test in the past or against the background of ongoing therapy is not in itself a contraindication to taking the drug Dopegyt ® . In cases where a positive direct Coombs test is detected while taking the drug, it is necessary to exclude the presence of hemolytic anemia in the patient and determine the clinical significance of this phenomenon.

Information about previous positive Coombs test results helps in assessing blood for cross-compatibility before transfusion. If during the treatment of a patient taking the drug Dopegyt ® there is a need for transfusion, then both direct and indirect Coombs tests must be performed before blood transfusion. In the absence of hemolytic anemia, only the direct Coombs test is usually positive. A positive direct Coombs test does not affect the determination of the blood group and the result of the test for cross-compatibility. If the indirect Coombs test is also positive, it may be difficult to assess cross-compatibility. In such cases, consultation with a hematologist or transfusiologist is necessary.

In rare cases, during therapy with methyldopa, the development of reversible leukopenia and granulocytopenia was observed. After cessation of therapy, the number of granulocytes returned to normal. In addition, rare cases of reversible thrombocytopenia have been reported in patients taking methyldopa.

In some patients, during the first three weeks of drug therapy, fever was observed, which was sometimes accompanied by eosinophilia or an increase in liver transaminase activity. In addition, taking methyldopa may be accompanied by the development of jaundice. Jaundice usually appears within the first 2-3 months of therapy. In some cases, cholestasis was confirmed against the background of jaundice. Very rarely, patients develop fatal necrotizing hepatitis. Liver biopsies taken from several patients with impaired function of this organ showed microscopic focal necrosis, characteristic of drug hypersensitivity. Before starting Dopegyt ® , at 6 and 12 weeks of treatment, and at any time when an unexplained fever occurs, it is recommended to determine the activity of hepatic transaminases and a complete blood count with a leukocyte formula.

If fever, jaundice or an increase in liver transaminase activity occurs, Dopegyt ® should be stopped immediately. If the appearance of these signs is associated with hypersensitivity to methyldopa, then after discontinuation of the drug, the fever will disappear, and liver function tests will return to normal values. Resuming the drug in such patients is not recommended. Patients with a history of liver disease should be treated with Dopegyt® with extreme caution.

Patients taking Dopegyt ® may need to reduce the dose of anesthetics. With the development of hypotension during general anesthesia, it is recommended to use therapy with vasopressors. Adrenergic receptors do not lose their sensitivity during methyldopa therapy.

Some patients taking methyldopa experience peripheral edema and weight gain. These side effects are easily eliminated with diuretics. With an increase in edema and the appearance of symptoms of heart failure, therapy with Dopegyt ® must be discontinued.

Since methyldopa is removed from the body by dialysis, an increase in blood pressure may be observed after the session is completed.

In patients with bilateral cerebrovascular disease (cerebrovascular disease), methyldopa may be accompanied by involuntary choreoathetotic movements. In such cases, drug therapy must be discontinued.

Dopegyt ® should be used with great caution in the treatment of patients with hepatic porphyria and their close relatives.

Therapy with Dopegyt ® may affect the results of measuring the concentration of uric acid (using a phosphorus-tungsten reagent), creatinine (using an alkaline picrate) and AST (colorimetric method) in the blood serum. The effect of methyldopa therapy on spectrophotometric analysis of AST concentrations has not been reported.

Against the background of methyldopa therapy, false-positive results of determining the content of catecholamines in the urine by a fluorescent method can be obtained, which complicates the diagnosis of pheochromocytoma. At the same time, methyldopa does not affect the assessment of the concentration of vanillylmandelic acid in the urine.

In rare cases, exposure to air may cause the urine of patients taking methyldopa to darken. This effect is associated with the decomposition of methyldopa and its metabolites. While taking the drug Dopegyt ® should not drink alcoholic beverages.

Influence on the ability to drive vehicles and control mechanisms

Therapy with Dopegyt ® may be accompanied by sedative effects, which are usually transient and develop at the beginning of treatment or with an increase in the dose of the drug. With the development of such effects, patients should not perform activities that require increased attention, for example, drive vehicles or mechanisms.

Helps stabilize high blood pressure drug "Dopegit". Reviews of doctors note that it acts quickly and effectively. It is inexpensive. Sold in almost every pharmacy. It is allowed to be taken by pregnant women. The medicine has contraindications, so you should not drink it without a doctor's prescription.

Composition and form of release

The drug "Dopegit" (reviews of experts confirm that this is the only medicine for pressure that is prescribed to pregnant women with hypertension) is available in tablets. The pills are white, slightly grayish in color. Contain about 282 mg of active substance - methyldopa sesquihydrate. This amount is identical to 250 mg of methyldopa. Additional components of the tablets are:

corn starch;
stearic acid;
talc;
sodium carboxymethyl starch;
ethylcellulose;
magnesium stearate.

Tablets are packed in dark glass bottles of fifty pieces. They are accompanied by instructions for use.

Pharmacological action of the drug

Dopegit tablets belong to vegetotropic antihypertensive drugs of central action (reviews of medical workers note that many women drink this medicine throughout pregnancy). Once in the body, the drug is converted to create alpha-methylnorepinephrine, which has a hypotensive effect by influencing certain mechanisms. The drug lowers sympathetic tone. This is due to the activation of the major inhibitory presynaptic α2 receptors.

The drug acts as a false neurotransmitter and replaces endogenous dopamine on dopaminergic nerve endings. Reduces the activity of renin in the blood and similarly affects the total peripheral resistance. Stops the synthesis of norepinephrine. Reduces the formation of adrenaline, dopamine, norepinephrine and serotonin due to the suppression of the activity of the enzyme dopa decarboxylase.

The active substance - methyldopa - does not affect the functioning of the cardiac organ and does not reduce cardiac output. Does not provoke the appearance of reflex tachycardia. Does not affect glomerular filtration rate. Does not affect the renal blood flow and does not exert any pressure on the filtered fraction.

Sometimes your heart rate may drop while taking medication. The drug quickly lowers the level of blood pressure. In rare cases, it can cause postural hypotension.

After the first intake of tablets, the greatest effect is observed after 4-6 hours and lasts from 12 to 24 hours. The medicine allows you to reduce pressure on the second or third day of taking the pills.

Indications

An indication for the use of the drug "Dopegit" (reviews say that the drug can be bought without problems at any pharmacy) is arterial hypertension. This medicine is very often given to pregnant patients.

Contraindications to the use of the drug

It is noted that the medicine "Dopegit" for pressure gives a good effect, reviews of doctors. Despite this, the drug is not prescribed for hepatitis in the acute stage of development and cirrhosis of the liver. A ban on the use is the pathology of the hepatic organ in history. Contraindication to use is treatment with MAO inhibitors. You can not drink pills with a depressive state, hemolytic anemia, as well as with myocardial infarction in the acute stage of development.

Do not prescribe a medicine for pheochromocytoma to children under the age of three and with special sensitivity to the constituent substances of the drug.

Patients with renal insufficiency should take tablets with extreme caution. This requires dose adjustment. Patients with diencephalic syndrome, the elderly, children from three years of age should be under medical supervision while taking the drug.

"Dopegit" during pregnancy and lactation

The drug "Dopegyt" has been actively used in obstetrics for more than fifty years. During this time, there were no incidents with a teratogenic effect of the drug on the fetus. As a result of clinical trials, the remote risk of the effects of tablets on the embryo was established.

The drug crosses the placenta during pregnancy, so patients in the "position" should be under constant medical supervision. "Dopegit" during lactation (reviews note that doctors do not recommend drinking pills when breastfeeding) is able to penetrate into breast milk. At the time of treatment, doctors advise to interrupt breastfeeding.

During pregnancy, drug therapy is started from the twentieth gestational week. Children born to women who were treated with "Dopegyt" did not have any complications. A completely different picture was observed in pregnant women who refused therapy with this drug. Their babies were born with neurological abnormalities that appeared due to prolonged oxygen starvation.

The drug "Dopegit" during pregnancy:

Reduces the resistance of peripheral vessels.
Reduces the production of renin.
Normalizes diastolic pressure.
Partially replaces dopamine - a component that increases blood pressure.
Has a mild sedative effect.

It has not been clinically proven that the medicine can harm the baby by passing through breast milk or the placenta. "Dopegit" instruction during pregnancy (reviews say that this drug does not harm the child) recommends prescribing when the intended benefit to the mother significantly outweighs the possible risk to the baby.

Method of application, dosage

The drug "Dopegit" is taken orally. Tablets are not chewed and washed down with water. Pills are taken half an hour before meals or 30 minutes after it.

The first two days, the medication is advised to drink 0.25 g three times a day. The dosage is set based on the level of blood pressure. With good tolerability of the drug, the dose is gradually increased every two days. After three days of treatment with Dopegyt, a slight calming effect appears.

The norm for patients with hypertension is 0.5-2 g. It is divided into equal shares and consumed up to four times a day. The maximum daily dosage is 3 g.

If, when taking a daily dose of 2 g, the treatment did not work, and the pressure decreases poorly, then Dopegyt is prescribed in combination with other antihypertensive drugs or replaced with another medicine.

The drug can be given to patients who use other antihypertensive drugs in therapy, but with the condition of their cancellation in the future. In this situation, treatment begins with 0.5 g per day, gradually, if necessary, the amount of the drug is increased at intervals of 48 hours.

Elderly people should start treatment with 0.125-0.25 g. They should not take more than 2 g per day. In children from three years old, the medicine is prescribed at the rate of 10 mg per kilogram of the child's weight. The resulting dosage is divided into several doses.

You can not take more than 65 mg of the drug per kilogram of weight, and the daily dosage should not exceed 3 g. After a three-month use of Dopegyt, tolerance to the drug often appears. In this case, diuretics and antihypertensive drugs are additionally prescribed.

Medicine "Dopegit": instructions for use during pregnancy

Reviews of experts note that the tablets are easily tolerated and practically do not cause side effects. Because of this, they are often prescribed in the gestational period. The drug has few contraindications and does not have a toxic effect on the fetus. This property makes it possible for pregnant women to take it for a long period, up to childbirth. During pregnancy, treatment with tablets should be accompanied by medical supervision and monitoring of blood tests.

They say that quickly normalizes the pressure "Dopegit" during pregnancy, reviews. The dosage is set by the doctor individually. First, the woman is examined. Then, according to the results of the analyzes, the dose is adjusted. Usually begin treatment with one tablet of 250 mg per day. See how the drug is tolerated. With good tolerance, the dosage is increased gradually, with an interval of two days. Take the drug until the pressure returns to normal. The maximum daily dose for pregnant women is 2 g.

"Dopegit" for ladies in position is assigned only in cases of emergency. Usually in the second and third trimesters. The drug is needed for pregnant women to prevent late gestosis, and for the fetus to develop normally.

The medicine helps to reduce pressure by 10-20%, which makes it possible for a pregnant woman to feel normal.

Side effects

Tablets "Dopegit" reviews of pregnant women are considered the best drug for stabilizing blood pressure. Despite this, the drug can cause such negative phenomena as drowsiness, lethargy, lethargy. When taking the medicine, sometimes there is paralysis of the facial nerve, dizziness, unsteadiness of gait, parkinsonism. Headaches, orthostatic hypertension, myocarditis, bradycardia, increased heart failure and angina pectoris occurred from taking the medication. Observed peripheral edema, hyperemia, pericarditis.

During therapy with Dopegyt, glossalgia, dryness of the oral mucosa, diarrhea, gag reflex, and colitis appeared. The patient may experience hepatotoxicity, jaundice and pancreatitis while taking the tablets. Leukopenia, agranulocytosis, hemolytic anemia and thrombocytopenia were recorded.

The drug can cause myalgia, gynecomastia and arthralgia. Provoke galactorrhea, amenorrhea and hyperprolactinemia. Reduce libido and potency.

In isolated cases, fever, Lyell's syndrome occurred during treatment. Patients were worried about skin rashes, exanthema. Nasal congestion and inflammation in the salivary glands were observed.

Expiration date, storage method

The drug is produced in Hungary by the EGIS company. The medicine should be stored at a temperature of +15 to +25°C. In a place protected from children and the sun. The shelf life of the tablets is five years. The medication should not be used after this period.

Medication cost

It is strongly recommended to consult a doctor before using the drug "Dopegyt" instructions for use. Reviews of doctors note that this medicine is the safest of all pressure-reducing drugs, which is why it is prescribed to pregnant women.

The medicine can be bought in almost every pharmacy. The price of 50 tablets of 250 mg varies around 200-250 rubles.

In this article, you can read the instructions for using the drug Dopegit. Reviews of site visitors - consumers of this medicine, as well as opinions of doctors of specialists on the use of Dopegyt in their practice are presented. A big request to actively add your reviews about the drug: did the medicine help or not help get rid of the disease, what complications and side effects were observed, perhaps not declared by the manufacturer in the annotation. Analogues of Dopegyt in the presence of existing structural analogues. Use for the treatment of arterial hypertension and pressure reduction in adults, children, as well as during pregnancy and lactation. Indications and contraindications for taking the drug.

Dopegit- antihypertensive drug of central action. It is metabolized to form alpha-methylnorepinephrine, which has a hypotensive effect through several mechanisms:

decrease in sympathetic tone by stimulating central inhibitory presynaptic alpha2 receptors;
substitution of endogenous dopamine at dopaminergic nerve endings (as a false neurotransmitter);
a decrease in the activity of renin in blood plasma and a decrease in OPSS;
suppression of the synthesis of norepinephrine, a decrease in the concentration of dopamine, serotonin, norepinephrine and adrenaline in tissues due to inhibition of the activity of the dopa decarboxylase enzyme.

Methyldopa (the active substance of the drug Dopegyt) does not have a direct effect on heart function, does not reduce cardiac output, does not cause reflex tachycardia, and does not reduce glomerular filtration rate, renal blood flow, filtered fraction. In some cases, the heart rate decreases. Effectively reduces blood pressure both in the supine position and standing. Rarely causes postural hypotension.

After taking a single oral dose, the maximum effect develops within 4-6 hours and lasts approximately 12-24 hours. With repeated use of the drug, the maximum reduction in blood pressure is achieved on days 2-3. After discontinuation of therapy, blood pressure returns to baseline within 1-2 days.

Compound

Methyldopa sesquihydrate + excipients.

Pharmacokinetics

The absorption of methyldopa from the gastrointestinal tract is approximately 50%. After oral administration, the bioavailability of methyldopa is about 25%. Plasma protein binding - less than 20%. Methyldopa crosses the placental barrier and is excreted in breast milk. The metabolism of methyldopa is intense. Methyldopa is metabolized primarily in the liver. The active metabolite of methyldopa, alpha-methylnorepinephrine, is formed in adrenergic neurons of the central nervous system. There are also some other methyldopa derivatives that are excreted by the kidneys. Approximately two-thirds of the absorbed methyldopa is excreted from the body by the kidneys unchanged, as well as in the form of sulfate compounds. The rest of the drug is excreted through the intestines (also unchanged). The active substance is completely excreted from the body within 36 hours.

Indications

arterial hypertension (to reduce pressure).

Release form

Tablets 250 mg.

Instructions for use and dosage

Tablets are taken orally before or after meals. The dosing regimen is set individually.

Adult patients

The recommended initial dose of Dopegyt in the first 2 days of therapy is 250 mg 2-3 times a day. Then the dose can be gradually increased or decreased (depending on the degree of reduction in blood pressure). The duration of the intervals between increasing and decreasing the dose of Dopegyt should be at least 2 days. Since within 2-3 days after the start of therapy, as well as with a subsequent increase in the dose, an adverse sedative effect of the drug may be observed, it is recommended to first increase the evening dose of the drug.

The standard maintenance dose of Dopegyt is 0.5-2 g per day. This dose is divided into 2-4 doses. The maximum daily dose of the drug should not exceed 3 g. In cases where, while taking the drug at a dose of 2 g per day, there is an insufficiently effective decrease in blood pressure, it is recommended to combine Dopegyt with other antihypertensive drugs. After 2-3 months of therapy, tolerance may develop to methyldopa. An effective reduction in blood pressure can be achieved by increasing the dose of the drug or the concomitant use of diuretics. 48 hours after discontinuation of therapy with Dopegyt, blood pressure usually returns to baseline. The "rebound effect" is not observed.

The drug Dopegyt can be prescribed to patients who are already receiving therapy with other antihypertensive drugs, subject to the gradual withdrawal of these drugs. In such cases, the initial dose of Dopegyt should not exceed 500 mg per day. Dose increases are carried out as needed, at intervals of at least 2 days.

When using the drug Dopegyt in addition to previously prescribed antihypertensive therapy, dose adjustment of antihypertensive drugs may be required to ensure a smooth transition.

Side effect

progression of angina pectoris
myocarditis
pericarditis
congestive heart failure
orthostatic hypotension (dose reduction is recommended)
peripheral edema
weight gain
sinus bradycardia
parkinsonism
peripheral facial paralysis (Bell's palsy)
decline in intelligence
symptoms of cerebrovascular insufficiency (possibly as a result of hypotension)
mental disorders (including nightmares, usually reversible mild psychosis and depression)
headache
sedation (usually transient)
general weakness
fatigue
dizziness
paresthesia
decreased libido
nasal congestion
pancreatitis
colitis
nausea, vomiting
diarrhea
inflammation of the salivary glands
pain or dark coloration of the tongue
constipation
bloating
flatulence
dryness of the oral mucosa
jaundice
toxic epidermal necrolysis
eczema or rash that resembles lichen
mild joint pain with or without swelling
myalgia
hyperprolactinemia, gynecomastia, galactorrhea, amenorrhea
vasculitis
lupus syndrome
drug fever
eosinophilia
positive Coombs test
hemolytic anemia, leukopenia, granulocytopenia, thrombocytopenia
impotence
ejaculation disorders.

Contraindications

acute hepatitis, cirrhosis of the liver;
a history of liver disease (against the background of taking methyldopa);
concomitant therapy with MAO inhibitors;
depression;
hemolytic anemia;
acute myocardial infarction;
pheochromocytoma;
children's age up to 3 years (for tablet form);
hypersensitivity to the drug.

Use during pregnancy and lactation

According to the results of clinical studies after the use of Dopegyt in the 2nd and 3rd trimesters of pregnancy, there were no signs of damage to the fetus or newborn. Since there have been no adequate and well-controlled studies in the 3rd trimester of pregnancy, the use of the drug is recommended only after a careful comparison of the expected benefit of therapy for the mother and the potential risk to the fetus.

A study of children born to mothers who took Dopegyt after the 26th week of pregnancy did not reveal any undesirable effects of the drug. In pregnant women who took the drug in the 3rd trimester, the condition of the fetus was better than in women who did not take the drug.

Use in elderly patients

For elderly patients, the drug is prescribed in the minimum initial dose, which should not exceed 250 mg per day. If necessary, the dose can be gradually increased. The duration of the intervals between increasing the dose of the drug is at least 2 days. The maximum daily dose of Dopegyt should not exceed 2 g.

Use in children

For children older than 3 years, the initial dose of the drug is 10 mg / kg of body weight per day. The daily dose is divided into 2-4 doses. If necessary, the dose can be gradually increased until the desired effect is achieved. Between the increase in the dose of the drug, an interval of at least 2 days must be observed. The maximum daily dose of Dopegyt is 65 mg/kg of body weight per day, but not more than 3 g per day.

Contraindicated in children under 3 years of age.

special instructions

In rare cases, patients taking methyldopa developed hemolytic anemia. When signs of anemia appear, it is necessary to determine the concentration of hemoglobin and hematocrit. If anemia is confirmed, the degree of hemolysis should be further assessed. In case of development of hemolytic anemia, therapy with Dopegyt should be discontinued. After discontinuation of therapy (with or without corticosteroids), remission is usually achieved quickly. However, in rare cases, deaths have been observed. Taking the drug Dopegyt is contraindicated in patients with hemolytic anemia that developed during therapy with this drug.

In some patients who have been taking Dopegyt for a long time, a positive Coombs test is determined. According to various researchers, the prevalence of this reaction varies from 10 to 20%. A positive Coombs' test is rarely observed during the first 6 months of therapy. If this phenomenon has not developed during the first 12 months of therapy, then in the future its detection is unlikely. The prevalence of a positive Coombs test is dose-dependent. This phenomenon is least often observed in patients taking the drug at a dose of 1000 mg per day or less. The Coombs test, which is positive while taking methyldopa, becomes negative several weeks or months after cessation of drug therapy. Before starting treatment, as well as at 6 and 12 months of therapy, it is recommended to perform a complete blood count and a direct Coombs test.

The detection of a positive Coombs test in the past or against the background of ongoing therapy is not in itself a contraindication to taking Dopegyt. In cases where a positive direct Coombs test is detected while taking the drug, it is necessary to exclude the presence of hemolytic anemia in the patient and determine the clinical significance of this phenomenon.

Information about previous positive Coombs test results helps in assessing blood for cross-compatibility before transfusion. If during the treatment of a patient taking the drug Dopegyt, it becomes necessary to conduct a transfusion, then both direct and indirect Coombs tests must be performed before blood transfusion. In the absence of hemolytic anemia, only the direct Coombs test is usually positive. A positive direct Coombs test does not affect the determination of the blood group and the result of the test for cross-compatibility. If the indirect Coombs test is also positive, it may be difficult to assess cross-compatibility. In such cases, consultation with a hematologist or transfusiologist is necessary.

In some patients, during the first three weeks of drug therapy, fever was observed, which was sometimes accompanied by eosinophilia or an increase in liver transaminase activity. In addition, taking methyldopa may be accompanied by the development of jaundice. Jaundice usually appears within the first 2-3 months of therapy. In some cases, cholestasis was confirmed against the background of jaundice. Very rarely, patients develop fatal necrotizing hepatitis. Liver biopsies taken from several patients with impaired function of this organ showed microscopic focal necrosis, characteristic of drug hypersensitivity. Before starting Dopegyt, at 6 and 12 weeks of treatment, and at any time when an unexplained fever occurs, it is recommended to determine the activity of hepatic transaminases and a complete blood count with a leukocyte formula.

If fever, jaundice or an increase in liver transaminase activity occurs, Dopegyt should be stopped immediately. If the appearance of these signs is associated with hypersensitivity to methyldopa, then after discontinuation of the drug, the fever will disappear, and liver function tests will return to normal values. Resuming the drug in such patients is not recommended. Patients with a history of liver disease should be treated with Dopegyt with extreme caution.

Patients taking Dopegyt may need to reduce the dose of anesthetics. With the development of hypotension during general anesthesia, it is recommended to use therapy with vasopressors. Adrenergic receptors do not lose their sensitivity during methyldopa therapy.

Since methyldopa is removed from the body by dialysis, an increase in blood pressure may be observed after the session is completed.

In patients with bilateral cerebrovascular disease (cerebrovascular disease), methyldopa may be accompanied by involuntary choreoathetotic movements. In such cases, drug therapy must be discontinued.

Dopegyt should be used with great caution in the treatment of patients with hepatic porphyria and their close relatives.

Therapy with Dopegyt may affect the results of measuring the concentration of uric acid (using a phosphorus-tungsten reagent), creatinine (using an alkaline picrate) and AST (colorimetric method) in the blood serum. The effect of methyldopa therapy on spectrophotometric analysis of AST concentrations has not been reported.

Influence on the ability to drive vehicles and control mechanisms

Therapy with Dopegyt may be accompanied by sedative effects, which are usually transient and develop at the beginning of treatment or with an increase in the dose of the drug. With the development of such effects, patients should not perform activities that require increased attention, for example, drive vehicles or mechanisms.

drug interaction

Dopegyt can not be used simultaneously with MAO inhibitors.

Simultaneous use with the following drugs requires special care.

Drugs that reduce the antihypertensive effect of the drug Dopegyt: sympathomimetics (increase the pressor effect), tricyclic antidepressants, phenothiazines (at the same time they may have an additive antihypertensive effect), oral iron preparations (they may reduce the bioavailability of methyldopa), non-steroidal anti-inflammatory drugs (NSAIDs) ), estrogenic drugs.

Drugs that enhance the antihypertensive effect of the drug Dopegyt: other antihypertensive drugs, beta-blockers (increased antihypertensive effect), levodopa + carbidopa (orthostatic hypotension may develop, in this case, patients after taking the drugs should be in a horizontal position for 1-2 hours) , general anesthetics, anxiolytic drugs (tranquilizers).

Dopegyt and the following drugs can change the effects of each other: lithium (danger of increasing lithium toxicity), levodopa (decrease in antiparkinsonian effect and increase undesirable effects on the central nervous system), ethanol (alcohol) and other drugs that depress the central nervous system (increased depression), anticoagulants (increased anticoagulant effect, risk of bleeding), bromocriptine (possibly an undesirable effect on the concentration of prolactin), haloperidol (possible impairment of cognitive functions - disorientation and confusion).

Analogues of the drug Dopegit

Structural analogues for the active substance:

Aldomet;
Dopanol.

In the absence of analogues of the drug for the active substance, you can follow the links below to the diseases that the corresponding drug helps with and see the available analogues for the therapeutic effect.

Last modified: October 1st, 2018 at 05:09 pm

In arterial hypertension, and conditions accompanied by an increase in blood pressure, various drugs with an antihypertensive effect are used, including Dopegyt. It has a small number of contraindications and side effects, quickly reduces performance and has a long-lasting effect. How to use Dopegyt from pressure, instructions and features of taking the drug.

The main active ingredient of the drug is methyldopa or a derivative of the substance (methidopa sesquihydrate) in a volume of 250 mg per tablet. Additional ingredients include stearic acid, talc, corn starch, ethyl cellulose, magnesium stearate. The agent belongs to the pharmacological category of stimulants of the central α2-adrenergic receptors.

Dopegyt helps to reduce pressure due to the normalization of the tone of the sympathetic nerves and the general resistance of the vascular walls, the reduction of the activity of a special enzyme in the blood plasma, which is involved in the increase in blood pressure. It inhibits the synthesis of stress hormones and reduces their concentration in the blood, without adversely affecting heart and kidney function, but is able to slow down the pulse and reduce the volume of circulating blood.

The ingredients of the drug equalize the pressure 4-6 hours after ingestion, eliminate the symptoms of hypertension (headaches, dizziness, nausea, weakness) and retain the effect throughout the day. The drug is available in the form of white or gray-white tablets, flat and round, with a dividing line in the middle and engraved in the form of the Latin name of the drug (DOPEGYT). The pills are packaged in dark glass containers of 50 pieces, one bottle in a carton box.

Attention: after discontinuation of the drug, blood pressure indicators return to baseline within 1-2 days, but in some cases a withdrawal syndrome is possible - the pressure rises sharply, which can lead to a hypertensive crisis.

Indications for use

Dopegyt is prescribed for hypertension II and III severity to lower blood pressure and relieve concomitant symptoms - headache, dizziness, nausea, palpitations.

Contraindications

Contraindications to the use of Dopegyt include:

depressed mental states;
anemia of hemolytic origin;
hormonally active neoplasms;
myocardial infarction in the acute phase;
severe renal and hepatic dysfunction (renal failure, acute hepatitis, cirrhosis);
low pressure;
individual intolerance to the ingredients of the drug;
age under 3 years old.

In the presence of diseases and conditions that are included in the list of contraindications to taking the drug, you need to consult a doctor to select an analogue.

Method of application and dosage

The dosage of methyldopa is selected depending on the age, characteristics of the organism and the clinical history of the patient. The standard dose is 1 tablet 2-3 times a day, after which the volume of the active substance is adjusted taking into account the reaction of the body, reducing or increasing the dosage.

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With maintenance therapy, it is recommended to drink 2-8 tablets daily, divided into 3-4 doses, the maximum amount is 12 tablets per day. If the pressure rises too high, and Dopegyt does not give the desired effect, medicine recommends adding an antihypertensive drug from another group to the treatment regimen.

For reference: the reason for the lack of a therapeutic effect from taking methyldopa is the body's tolerance for a substance that is produced over time, so a remedy with its content should be taken in combination with diuretics or other drugs.

Permissions and prohibitions on use

adults

In the absence of serious diseases, the initial dose of the active component of the drug is 1 tablet 2-3 times a day, after which it can be increased, and at least 2 days should elapse between increasing and decreasing the dose. Dopegyt can be taken both independently and as part of complex therapy along with other drugs against hypertension.

Elderly age

In old age, the initial dose of methyldopa is 1 tablet daily, with a normal reaction of the body, it can be increased, the maximum allowed is 4 tablets per day. In the treatment of Dopegyt in mature patients, syncope associated with atherosclerotic changes in the vascular system is possible - they can be avoided by reducing the dosage.

Children

You can use Dopegyt in childhood, starting from 3 years old, the initial dosage is calculated according to the following formula - 10 mg / kg of body weight daily. In the absence of the desired effect, the dose can be increased to 65 mg / kg body weight, but the maximum daily dosage should not exceed 3 g.

Important: the ban on the use of methyldopa at the age of less than 3 years is associated with the lack of sufficient information about the effect of the substance on the children's body. In exceptional cases, the drug is used to treat infants and children under three years of age under strict medical supervision.

For impaired renal function

Tablets are excreted mainly in the urine, respectively, when prescribing Dopegyt therapy to patients with impaired renal function, the dosage should be reduced. With a mild stage of the disease, the interval between doses of the drug should be increased to 8 hours, with moderate pathology - up to 8-12 hours, with severe disorders - up to 12-24 hours. Methyldopa is washed out of the body during dialysis, so after the procedure it is recommended to take an additional pill to prevent pressure surges.

During pregnancy and lactation

Dopegyt is one of the few drugs that are approved for use in high blood pressure in pregnant women. Clinical studies conducted during pregnancy in the first and second trimester did not reveal a serious threat to the life and development of the fetus. No relevant analyzes were performed for the third trimester - during this period, when prescribing the drug, it is necessary to correlate the benefits and possible risks to the health of the mother and child.

As a rule, an increase in blood pressure causes more harm to the fetus than the use of methyldopa, so doctors do not recommend using drugs containing a substance to eliminate the symptoms of the disease.

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The use of Dopegyt during lactation requires strict medical supervision. The active ingredients of the drug are able to penetrate into breast milk, and in order to eliminate the risk of deterioration, it is recommended to transfer the baby to artificial feeding.

Adverse reactions and overdose

Dopegyt is able to cause side effects from different organs and systems that develop with different frequency. Possible unwanted effects include:

drowsiness, feeling of weakness and weakness;
decrease in pressure, heart failure, swelling of the extremities;
mental disorders, headaches, circulatory disorders (finger tremor, facial paresis);
digestive disorders - abdominal discomfort, nausea, diarrhea, flatulence, increased gas formation;
rhinitis, dry mucous membranes, bad breath, discoloration of the surface of the tongue;
rashes on the skin, itching, urticaria;
pain, aches in the joints and muscles;
fever and chills;
menstrual disorders in women, potency and hormonal levels in men;
changes in clinical blood tests.

Adverse reactions of the body are possible and Dopegyt together with some medicinal preparations. The use of methyldopa and products containing ethanol (this list includes not only medicines, but also alcoholic beverages) can cause toxic liver damage, and the use of anticoagulants increases the risk of bleeding. Antacids, antidepressants, non-steroidal anti-inflammatory drugs, iron- and estrogen-containing drugs reduce the antihypertensive effect of the drug.

The use of excessive doses of the drug causes increased side effects, vascular insufficiency, severe dysfunction of the kidneys, liver and intestines. With the development of overdose symptoms, it is necessary to induce vomiting in the patient, wash the stomach and use enterosorbents, and then immediately take him to the hospital.

Tip: The most common side effect of taking Dopegyt is drowsiness and decreased performance, so if you need to increase the dosage, the drug should be taken before bedtime.

Analogues

The list of available analogues of Dopegyt includes the following drugs:

bisoprolol;
Captopril;
Moxonidine;
Lorista;
Alphadopa;
Dopanol.

Medicines from this list have a similar effect on the body, but the decision to replace the drug should be made by the doctor, taking into account the age and characteristics of the patient's body.

Arterial hypertension is one of the most common diseases of the cardiovascular system. According to statistics, 20-30% of adult cardiological patients suffer from it. By the age of 65, the risk of developing pathology doubles.

Antihypertensive drugs that affect the mechanisms of the central nervous system that regulate blood pressure help fight the disease. These drugs include Dopegyt. Let us consider in more detail what kind of remedy it is, when it is prescribed, and whether there are contraindications to its use.

Dopegyt is a centrally acting antiadrenergic antihypertensive drug related to central alpha2-adrenergic receptor stimulants.

Forms, composition and cost

The drug is produced in tablet form (250 mg) in dark glass bottles of 50 pcs. Producer - Egis (Hungary).

You can buy the drug by prescription. The cost depends on the form of the drug and the pricing policy of a particular pharmacy. Estimated price by region is presented in the table (Table 1).

Table 1 - Cost of Dopegyt

This medicine contains the active ingredient methyldopa sesquihydrate 250 mg. Of the excipients in the tablets include:

ethyl cellulose ether;
magnesium stearate;
corn starch;
octadecanoic acid;
carboxymethylcellulose;
talc.

Pharmacodynamics and pharmacokinetics

Dopegyt takes part in the metabolic reactions of the body and forms alpha-methylnorepinephrine, which has a hypotensive effect due to:

Methyldopa sesquihydrate does not affect myocardial function, does not decrease cardiac output, does not increase heart rate, and does not reduce glomerular filtration and renal blood flow. Effectively reduces pressure in any position of the body. Rarely causes orthostatic hypotension.

When taking a single dose orally, the maximum effect develops after 4-6 hours and lasts about 12-24 hours. Repeated use of the medication reduces the pressure as much as possible for 2-3 days. After completion of therapy, the pressure level returns to its original values within one to two days.

Dopegyte enters the CNS through the physiological barrier between the circulatory system and the central nervous system. There, about 10% of the active substance is easily decarboxylated into dimethyldopamine and the active a2-adrenergic agonist methylnorepinephrine. The half-life of the drug product is 2 hours. It is excreted by the kidneys mainly unchanged.

Instructions for use

Dopegit is prescribed, starting from the individual characteristics of the patient and taking into account the existing contraindications.

Indications and contraindications

The drug based on methyldopa sesquihydrate Dopegyt is intended for the treatment of mild to moderate hypertension, including hypertension in pregnant women.

This medication is not prescribed to patients with:

Also, the drug is not used when taking the antiparkinsonian drug Levodopa and monoamine oxidase inhibitors.

Dopegyt is used with caution during lactation. Also, they try not to prescribe it to patients with hepatitis, hypothalamic syndrome, acute left ventricular failure.

According to clinical studies, there were no signs of congenital pathologies of the newborn or violations of intrauterine development of the fetus during treatment with the drug in the second and third trimester of pregnancy. But it is recommended to prescribe Dopegit to patients during this period according to strict indications, when treatment cannot be dispensed with.

Dosage and features of admission

Adults are recommended oral administration, at the beginning of therapy - 250 mg in the evening (in the first 2 days). In the next every two days, a single dose is increased by 250 mg until the desired therapeutic effect is achieved (often it is noted with a daily dose of 1 g, divided into 2-3 doses).

Increase evening dose first to reduce sedation. The maximum daily intake of the drug is 2 g. Complex treatment with other antihypertensive medications provides for a maximum daily dosage of not more than 500 mg. The intake of tablets is gradually reduced to the level of the minimum dosage, when a stable hypotensive effect appears.

The initial daily intake for children is 10 mg / kg, divided into 2-4 approaches. The maximum daily dose of Dopegyt for children should not exceed 65 mg/kg of body weight.

For elderly patients, it is recommended to use an initial dose of 125 mg 1-2 times a day. The maximum daily intake is 2 g, divided into 2 sets. Patients with kidney disease are advised to reduce a single dose of medication.

After 2-3 months of regular use of Dopegyt, resistance to the active ingredients may develop in the body. In this case, you can effectively lower the pressure with the help of diuretics and a competent increase in the dosage of the main drug.

Possible side effects

In patients with hypersensitivity and individual intolerance to the components of the medication, allergic manifestations are possible. At the beginning of therapy, as well as with an increase in dosage, there may be:

weakness, lethargy, irresistible drowsiness, lethargy;
attacks of cephalalgia and dizziness;
increased fatigue;
these symptoms quickly disappear as soon as the period of adaptation passes.

Of the side effects, the following signs are noted:

Elderly patients sometimes experience fainting. This phenomenon is associated with increased susceptibility to the active substances of Dopegyt and atherosclerotic lesions of the cerebral vessels. The development of syncope can be prevented by reducing the dosage of the drug.

Dopegyt during pregnancy and lactation

Often, when carrying a child, women are diagnosed with hypertension, which is accompanied by excruciating nausea, lethargy, dizziness, and drowsiness. High blood pressure increases the risk of premature delivery. To avoid an undesirable outcome of pregnancy, gynecologists often prescribe Dopegyt.

Indications and action

Dopegyt is recommended for use when hypertension is diagnosed in a pregnant woman. During this period, patients often have problems with the vessels and the circulatory system, as a result of which the pressure can suddenly increase.

The drug is used in the last two trimesters of bearing a child. At an earlier date, clinical trials were not conducted, and there is no data on the effect of the drug on the early intrauterine development of the fetus during this period. Tablets are allowed to drink until the very birth.

The drug has no taste and smell, so it does not cause a gag reflex and disgust when taken. Medication during pregnancy:

normalizes pressure;
soothes;
reduces the gag reflex;
relieves headaches;
eliminates dizziness;
reduces the heart rate.

Dosage

Tablets are taken orally before the main meal (it is possible after a meal). The positive effect will be noticeable 3-7 hours after the first application. The duration of the therapeutic effect is 12-24 hours. It is allowed to take no more than 8 tablets per day for 2-3 approaches.

At the beginning of treatment, patients are prescribed 1 tablet per day. Gradually, the drug is increased to the required dosage. It is different for every pregnant woman. As soon as the pressure indicators return to normal, unpleasant symptoms disappear, the dosage is reduced, bringing the daily intake to 1 tablet every 2-3 days.

Negative consequences

When taking the drug in pregnant women, the following side effects were noted:

drowsiness;
prostration;
headache;
puffiness.

Rarely:

myocardial infarction;
angina;
indigestion;
joint and muscle pain.

In case of an overdose, the following symptoms may develop:

low pressure;
lethargy;
hallucinations;
difficulty with defecation.

This drug is an antihypertensive agent, which is released only by prescription.

Application during breastfeeding

During breastfeeding, it is undesirable to take Dopegyt, since its active components are able to penetrate into breast milk. Therapy is possible if there is a risk to the mother.

The standard dosage for a nursing woman is 0.25 g in two divided doses. The doctor can change the dosage after observing the condition of the woman.

Since the drug penetrates into milk, in order to protect the baby, it is temporarily transferred to artificial feeding. To maintain lactation, and to avoid stagnation, milk is expressed and discarded. You can resume feeding after the expiration of the drug course.

Analogues

Dopegyt has many analogues that can be used if this drug cannot be taken for any reason.

Structural

Among the funds, identical in active ingredient, can be called:

Drugs of other groups with a similar effect

No less effective are the following drugs based on other active ingredients, but having a similar effect on the body:

The use of any analogue must be agreed with the doctor, since all of the listed medicines have their own contraindications and require the appointment of a certain dosage that corresponds to the individual characteristics of patients.