Lawson D H, Gloss D, Jick H
Am Heart J. 1978 Nov;96(5):572-9. doi: 10.1016/0002-8703(78)90192-8.
Of 26,294 consecutive patients monitored in a comprehensive drug surveillance program, 1067 (4 per cent) received methyldopa for treatment of hypertension. Adverse reactions attributed to methyldopa were reported in 149 patients (14 per cent), the most frequent being hypotension. Life-threatening adverse effects were reported in nine patients (6 per cent of reactors)--the major problems being hypotension associated in several patients with signs of cardiac or cerebral ischemia. Hypotension attributed to methyldopa was more frequent in younger patients, in those with uremia, in lighter subjects, and in those receiving a high daily dose. Marked interaction between these factors was demonstrated and eightfold differences in the frequency of hypotension were observed in different sub-groups of methyldopa recipients. Adverse effects other than hypotension were reported infrequently and did not correlate well with the previously mentioned factors. The findings suggest that methyldopa therapy should be commenced cautiously in younger patients, in the non-obese, and in those with impairment of renal function as manifest by elevated blood urea nitrogen levels.
在一项全面药物监测项目中对26294例连续监测的患者进行观察，其中1067例（4%）接受甲基多巴治疗高血压。149例（14%）患者报告了与甲基多巴相关的不良反应，最常见的是低血压。9例患者（占不良反应患者的6%）报告了危及生命的不良反应——主要问题是低血压，部分患者伴有心脏或脑缺血迹象。甲基多巴所致低血压在年轻患者、尿毒症患者、体重较轻者以及每日高剂量用药者中更为常见。已证实这些因素之间存在显著相互作用，在接受甲基多巴治疗的不同亚组中，低血压发生率观察到八倍的差异。除低血压外的其他不良反应报告较少，且与上述因素相关性不佳。研究结果表明，对于年轻患者、非肥胖患者以及肾功能受损（表现为血尿素氮水平升高）的患者，开始甲基多巴治疗时应谨慎。
