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Here comes the answer 45..the persistent Bp

Here comes the answer 45..the persistent Bp

In our Monday edition of can you deliver, we shared a case of a patient on certain drugs including methyldopa and ferrous. As usual, we had some very insightful comments from our professional readers, the answers we anticipated has already been supplied by Rxbdagirl (don’t know why she chose this kind of name…lol), however, some of our readers raised some other concerns and gave us another angle to look at it. For the records, the persistent high bp was as a result of concomitant administration of methyldopa and iron, (in the form of dedeons and ferrous).
According to the 36th edition of martindale , after concomitant administration of methyldopa and iron, results in healthy subjects indicated that the absorption of methyldopa was reduced by 73% and 61% respectively when taken with a dose of ferrous sulfate or ferrous gluconate, 5 hypertensive patients taking methyldopa were also given ferrous sulfate 325 mg three times daily for 2 weeks.1 All patients experienced a rise in systolic pressure, and 4 had a rise in diastolic pressure, amounting to more than 15/10 mmHg in some patients after 2 weeks. Blood pressure fell again when the ferrous sulfate was stopped.
Also, apregnanat woman on methyldopa that requires iron as a routine drug or prescribed, should take them 2-3 hours apart, to reduce a possible interaction to the barest minimum.
If you missed the question click the persistent bp
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References:
1.martindale, the complete drug reference,36th edition,page 1335
Campbell N, et al. Alteration of methyldopa absorption, metabolism, and blood pressure control caused by ferrous sulfate and
ferrous gluconate. Clin Pharmacol Ther 1988; 43: 381–6 read more

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