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methyldopa / HCTZ

Generic Aldoril
Used for Hypertension
Used for Hypertension

Methyldopa/hydrochlorothiazide is a combination of two medications to help treat high blood pressure, but it shouldn't be used as an initial treatment option. Your provider must start you on the individual medications, methyldopa and hydrochlorothiazide first before you can take this combination. Methyldopa/hydrochlorothiazide is a convenient option for people who tolerate the two separate medications and prefer to take one pill, but it was discontinued in the U.S. and is no longer available.

Reviewed by:
reviewer
Yen Nguyen, PharmD
reviewer
Michelle Nguyen, PharmD
Last reviewed on January 18, 2022
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageInteractionsContraindicationsAlternativesPricesMedicare
basics-icon

What is Methyldopa/hydrochlorothiazide?

What is Methyldopa/hydrochlorothiazide used for?

  • High blood pressure (hypertension)

How Methyldopa/hydrochlorothiazide works

Methyldopa/hydrochlorothiazide is a combination of two medications that work together to lower blood pressure:

  • Methyldopa is an alpha-2 adrenergic receptor agonist. It tells the brain to lower the activity of stress hormones so your blood vessels can relax.

  • Hydrochlorothiazide is a thiazide diuretic (water pill). It works in your kidneys to help get rid of extra water and electrolytes, like sodium, chloride, and potassium, in order to lower your blood pressure.

Are you looking for information on methyldopa instead?

Drug Facts

Common BrandsAldoril (brand no longer available)
Drug ClassAlpha-2 adrenergic receptor agonist / Diuretic (water pill)
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityDiscontinued
basics-icon

What are the side effects of Methyldopa/hydrochlorothiazide?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Temporary sleepiness
  • Temporary headache
  • Temporary weakness
  • Low blood pressure
  • Dizziness
  • Sensitivity to light

Other Side Effects

  • Swelling
  • Weight gain
  • Slow heart rate
  • Nausea
  • Vomiting
  • Diarrhea
  • Dry mouth
  • Lightheadedness
  • Pins and needles feeling
  • Joint or muscle pain
  • Stuffy nose
  • Rash
  • Absent period
  • Breast enlargement
  • Lower sex drive

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Electrolyte imbalance: dry mouth, extreme thirst, weakness, tiredness, sleepiness, restlessness, confusion, seizures, muscle pain or cramps, low blood pressure, trouble urinating, irregular heart beat, nausea, or vomiting
  • Hemolytic anemia: paleness of skin, dark urine, fever, weakness, confusion, or yellowing of eyes and skin
  • Liver damage: unsual vomiting, pale stools, dark urine, stomach pain, or yellowing of the eyes and skin

Source: DailyMed

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Rare

Unexplained fever shortly after starting to take this medicine

Check with your doctor as soon as possible if any of the following side effects occur:

Signs and symptoms of too much potassium loss

Dry mouth

increased thirst

irregular heartbeats

muscle cramps or pain

nausea or vomiting

unusual tiredness or weakness

weak pulse

Less common

Mental depression or anxiety

nightmares or unusually vivid dreams

Rare

Cough or hoarseness

dark or amber urine

diarrhea or stomach cramps (severe or continuing)

fever, chills, troubled breathing, and fast heartbeat

general feeling of discomfort or illness or weakness

joint pain

lower back or side pain

painful or difficult urination

pale stools

skin rash, hives, or itching

stomach pain (severe) with nausea and vomiting

tiredness or weakness after having taken this medicine for several weeks (continuing)

yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Dizziness or light-headedness when getting up from a lying or sitting position

drowsiness

dryness of mouth

headache

Less common

Decreased sexual ability or interest in sex

diarrhea

increased sensitivity of skin to sunlight (skin rash, itching, redness or other discoloration of skin or severe sunburn after exposure to sunlight)

loss of appetite

numbness, tingling, pain, or weakness in hands or feet

slow heartbeat

stuffy nose

swelling of breasts or unusual milk production

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Methyldopa/hydrochlorothiazide

thumbs-up

Pros

Two medications combined into one pill

Two different strengths available

Hydrochlorothiazide can help offset the swelling and weight gain side effects from methyldopa

thumbs-down

Cons

Generally needs to be taken multiple times a day

Not for initial treatment of high blood pressure

Raise the risk of sunburn and skin cancer

Not a good option for people with liver problems

pharmacist-tips

Pharmacist tips for Methyldopa/hydrochlorothiazide

pharmacist

  • Wear sunscreen and protective clothing when going outside because methyldopa/hydrochlorothiazide can make your skin more sensitive to sunlight and raise your risk of sunburns and skin cancer.

    • Methyldopa/hydrochlorothiazide can cause swelling or weight gain. This can be dangerous if you have heart failure. Let your provider know if you develop this side effect.

      • Although rare, methyldopa/hydrochlorothiazide can cause uncontrollable figeting or movement in certain people. Speak to your provider about stopping this medication if that happens.

        • Your provider might order labs before starting methyldopa/hydrochlorothiazide and periodically throughout your treatment to check your liver function and electrolyte levels.

          • Let your provider know if you are getting dialysis because methyldopa/hydrochlorothiazide might be removed during the process and not work as well in controlling your blood pressure.

            • Before going for parathyroid function tests, let your provider know that you are taking methyldopa/hydrochlorothiazide because this medication needs to be stopped before your test.

              • Let your provider know if you are pregnant, planning to become pregnant, or if you're breastfeeding. It's not known if methyldopa/hydrochlorothiazide can harm your unborn baby, but this medication can pass into the placenta and your breastmilk.

                faqs

                Frequently asked questions about Methyldopa/hydrochlorothiazide

                How long does it take for methyldopa/hydrochlorothiazide to lower my blood pressure?
                Your blood pressure will be lowered 4 to 6 hours after taking methyldopa/hydrochlorothiazide. Once your provider determines a dose that works best for you, your blood pressure will remain steady 12 to 24 hours after you take the medication.
                Can I drink alcohol while taking methyldopa/hydrochlorothiazide?
                Drinking alcohol together with methyldopa/hydrochlorothiazide can lower your blood pressure level, especially when standing from a sitting or lying down position. Talk to your provider if you drink alcohol often or in high amounts before starting methyldopa/hydrochlorothiazide to see if this mediation is right for you.
                Will methyldopa/hydrochlorothiazide cause drowsiness?
                Methyldopa/hydrochlorothiazide can cause drowsiness, especially when you first start taking the medication or when the dose is raised. For this reason, don't drive or do anything that requires concentration until you know how this medication affects you.
                Is methyldopa/hydrochlorothiazide safe for everyone?
                Discuss with your provider regarding your health conditions and current medications before starting methyldopa/hydrochlorothiazide. Methyldopa/hydrochlorothiazide might affect uric acid, blood sugar, and cholesterol levels so it might not be the best option for everyone.
                Can other blood pressure medications be taken together with methyldopa/hydrochlorothiazide?
                Some people might need more than medication to control their blood pressure. Depending on your health conditions and blood pressure levels, your provider might put you on multiple therapies. When methyldopa/hydrochlorothiazide is taken together with other blood pressure medications, it can intensify the effect of the medications so be sure to monitor for side effects or blood pressure levels that are too low.
                Why was methyldopa/hydrochlorothiazide discontinued?
                Both brand and generic versions of methyldopa/hydrochlorothiazide have been discontinued, but the reason for discontinuation is unknown. It's possible the medication was not used as frequently as other blood pressure medications, so the manufacturer stopped making it.
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                What are the risks and warnings for Methyldopa/hydrochlorothiazide?

                Methyldopa/hydrochlorothiazide can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

                risk-warning

                Not for initial therapy

                Methyldopa/hydrochlorothiazide is not for initial therapy to lower your blood pressure. Your provider must start you on the two medications, methyldopa and hydrochlorothiazide, separately and adjust your dose according to your response to the medications and your blood pressure levels.

                risk-warning

                Electrolyte imbalance

                • Risk factors: Dehydration | Vomiting | Taking other medications that affect your electrolytes

                  Methyldopa/hydrochlorothiazide can cause your electrolytes, such as sodium, chloride, potassium, and magnesium, to be out of balance. Sometimes, this can be dangerous. You're at a higher risk for this problem if you're dehydrated, vomiting, or also taking other medications that affect your electrolytes. If you're not sure whether your other medications, supplements, or food products can change your electrolyte levels, ask your provider. Get medical help if you experience symptoms of electrolyte imbalance such as dry mouth, extreme thirst, weakness, tiredness, sleepiness, restlessness, confusion, seizures, muscle pain or cramps, low blood pressure, trouble urinating, irregular heart beat, nausea, or vomiting.

                  risk-warning

                  Breakdown of red blood cells (hemolytic anemia)

                  • Risk factors: Taking methyldopa/hydrochlorothiazide for a long time | Positive Coombs test

                    Taking methyldopa/hydrochlorothiazide for a long time can cause people to get a positive Coombs test, which means that your body is attacking your red blood cells. This usually happens between 6 and 12 months after you start taking methyldopa/hydrochlorothiazide. Although very rare, this can lead to a serious and life-threatening condition called hemolytic anemia, where your red blood cells are destroyed faster than they are made. If you're going to be taking methyldopa/hydrochlorothiazide for a long time, your provider will have you get a blood test before and regularly throughout your treatment.

                    risk-warning

                    Liver problems

                    • Risk factors: History of or current liver problems

                      Although rare, methyldopa/hydrochlorothiazide can cause liver problems, which can be life-threatening in some cases. If you have a history of or current liver problems, talk to your provider for an alternative medication. Let your provider know right away if you get a fever or experience any symptoms of liver damage, such as unsual vomiting, pale stools, dark urine, stomach pain, or yellowing of the eyes and skin while taking methyldopa/hydrochlorothiazide.

                      risk-warning

                      Low white blood cell count

                      In some rare cases, methyldopa/hydrochlorothiazide can lower the number of white blood cells in your body. White blood cells are needed for your immune system to fight off infections. With a lower level of white blood cells, you can get sick easier or have a harder time recovering from an infection. This problem is temporary and will go away once you stop taking methyldopa/hydrochlorothiazide.

                      risk-warning

                      Gout

                      • Risk factors: History of gout | Current kidney problems

                        Methyldopa/hydrochlorothiazide can raise uric acid levels in your body, which might cause or worsen gout.

                        risk-warning

                        High blood sugar levels

                        • Risk factors: Diabetes

                          Methyldopa/hydrochlorothiazide might raise your blood sugar levels. If you have diabetes, check your blood sugar more regularly and let your provider know you're taking methyldopa/hydrochlorothiazide in case they need to adjust your diabetes medications.

                          dosage

                          Methyldopa/hydrochlorothiazide dosage forms

                          Typical dosing for Methyldopa/hydrochlorothiazide

                          The typical starting dose is 250 mg/15 mg (methyldopa/hydrochlorothiazide) by mouth two to three times a day, or 250 mg/25 mg (methyldopa/hydrochlorothiazide) two times a day. The dose can vary greatly depending on your previous dose and your response to the two separate medications, methyldopa and hydrochlorothiazide.

                          interactions

                          Interactions between Methyldopa/hydrochlorothiazide and other drugs

                          Methyldopa/hydrochlorothiazide may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Methyldopa/hydrochlorothiazide. Please note that only the generic name of each medication is listed below.

                          Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

                          Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                          Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                          contraindications-icon

                          Methyldopa/hydrochlorothiazide contraindications

                          Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Methyldopa/hydrochlorothiazide will not be safe for you to take.

                          • Current liver problems

                          • Liver problems related to previous use of methyldopa

                          • Unable to produce urine (anuria)

                          • Take medications called monoamine oxidase (MAO) inhibitors

                          • Allergy to sulfonamide medications

                          alternatives

                          What are alternatives to Methyldopa/hydrochlorothiazide?

                          There are a number of medications that your doctor can prescribe in place of Methyldopa/hydrochlorothiazide. Compare a few possible alternatives below.
                          Methyldopa/hydrochlorothiazide
                          Used for:

                          • High blood pressure (hypertension)

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                          Fosinopril/hydrochlorothiazide
                          Used for:

                          • High blood pressure

                          $46.43 Lowest GoodRx priceView Prices
                          Tekturna HCT
                          Used for:

                          • High blood pressure

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