Dopegit in pregnancy

Dopegit during pregnancy is the number one remedy for the treatment of late gestosis. To fully understand the need for this drug, it is necessary to know the causes of toxicosis in pregnant women.

Gestosis is a condition of a woman that develops in connection with pregnancy and is caused by the presence of a fertilized egg in the uterine cavity and has various clinical manifestations. According to the time of occurrence, gestosis is divided into early and late. Early ones occur in the first half of pregnancy and are associated with the development and formation of the placenta. The fetus is an agent foreign to the woman's body, because it contains 50% of the information from the father. The woman's immune system perceives it as an antibody to some extent, therefore, until the formation of its placenta with an individual barrier and blood flow, the child is a target. Therefore, a number of manifestations arise, which are called early gestosis. These include nausea, vomiting, hypersalivation, dermatosis. These manifestations do not require intensive drug therapy if they do not disturb the general condition of the woman. They usually go away on their own after the placenta has formed.

Late gestosis occurs in the second half of pregnancy. It is caused by a polysystemic polyorgan reaction to fetal development. That is, it is a reaction of the mother's body itself, which is a more serious and dangerous phenomenon requiring medical intervention. Late gestosis includes:

• HELLP syndrome is a symptom complex that includes intravascular hemolysis, elevated liver enzymes, and a decrease in the number of platelets in the peripheral blood.
• Fatty liver disease.
• Preeclampsia of mild, moderate and severe degrees.
• Eclampsia.

These conditions pose a direct threat to the life of the woman and child, and therefore require mandatory qualified intervention.

One of these conditions is preeclampsia – increased blood pressure combined with proteinuria in a woman during late pregnancy. It is necessary to distinguish between primary preeclampsia or gestational hypertension, which was not observed in a woman before and develops only during pregnancy no earlier than the 20th week, and chronic – increased pressure before the 20th week or hypertension in a woman before pregnancy. The treatment of these two pathologies has distinctive features.

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Main characteristics of dopegite

Indications for the use of dopegit: this medication is prescribed to treat hypertension in pregnant women. In elderly people, the drug is used to treat Parkinson's disease.

Release form: Dopegit is available in the form of 250 mg tablets.

Pharmacokinetics and pharmacodynamics: Dopegyt or methyldopa is a central antihypertensive agent that reduces blood pressure by stimulating alpha-2-adrenoreceptors. Stimulation of these receptors is accompanied by depression of the sympathetic nervous system and a decrease in nerve impulses, which is manifested in the relaxation of peripheral arterial vessels. In addition, dopegyt reduces the content of renin in plasma, thereby increasing blood flow to the kidneys and complementing its antihypertensive effect. It also reduces heart rate and cardiac output.

The drug begins to act four to six hours after administration, but its effect lasts for almost a day or a day and a half, which allows you to take the daily dose only once.

The drug is half absorbed in the gastrointestinal tract, and then about ten percent penetrates the blood-brain barrier, which corresponds to the maximum effect. Dopegit is excreted by the kidneys. The half-life of the substance is about two hours.

Contraindications and side effects of dopegit during pregnancy: the main contraindications are liver pathology with cytolysis syndrome, acute renal failure, hepatitis, hemolytic hereditary anemia, the use of drugs that act on the central nervous system, acute and chronic heart pathologies in a state of decompensation.

Main side effects:

• a condition of the central nervous system in the form of lethargy, fatigue, mood changes, decreased performance, dizziness.
• pressure drops in the form of orthostatic hypertension at first use.
• changes in internal organs: enlargement of the liver and spleen, jaundice, increased concentration of liver enzymes, nausea and vomiting, impaired intestinal motility.
• influence on hematopoiesis in the form of suppression of the hematopoietic germ.
• changes in immune status and allergic manifestations.

Dopegit dosages during pregnancy: the drug is prescribed at 250 milligrams, starting with the lowest dose, i.e. one tablet. For the first dose, methyldopa is prescribed at night, and then the amount of the drug is increased to the minimum dose, which effectively maintains the pressure level within the normal values. The optimal frequency of use is 3-4 times a day.

The maximum dose of dopegit during pregnancy is 3 grams per day.

The medication should be discontinued gradually, according to the same principle as it was prescribed, leaving the lowest dose that controls the pressure.

An overdose of the drug is manifested by a decrease in blood pressure, weakness, hypodynamia, lethargy, a decrease in heart rate, drowsiness, and a decrease in intestinal tone and motility.

Interaction of dopegit with other medications: Simultaneous use of methyldopa with drugs that affect the central nervous system (antidepressants, MAO inhibitors), as well as with similar alpha-adrenomimetics, can increase the side effects of the drug. Then severe difficult-to-control hypotension can be observed. Use with beta-blockers increases the risk of developing acute vascular insufficiency. And the simultaneous use of non-steroidal anti-inflammatory drugs reduces the antihypertensive effect of dopegit.

Storage conditions and periods – the shelf life is no more than 18 months, it is necessary to ensure a temperature regime of no more than twenty-five degrees and protect from the direct influence of low temperatures and humidity.

Is it possible to take Dopegit during pregnancy?

The issue of antihypertensive therapy during pregnancy is of great importance, because any medications prescribed to the mother enter the fetus's bloodstream and affect its development. The issue of harm from medications to the child is discussed very often, and the consensus that can be expressed is that there are no medications that would not affect the fetus, but here the lesser of two evils must be chosen. That is, a drug whose effect on the fetus is not teratogenic has an advantage in use.

Now it is worth understanding which antihypertensive drugs are recommended for the treatment of preeclampsia.

There are five main groups of antihypertensive drugs in therapy – ACE inhibitors, angiotensin II receptor blockers, beta blockers, diuretics and calcium antagonists. In pregnant women, the principles of using these drugs are slightly different.

ACE inhibitors are strictly contraindicated for pregnant women, as they affect the kidneys of the fetus - they suppress their excretory function and contribute to the development of oligohydramnios, especially in the second and third trimesters. If a woman took these drugs before pregnancy, they should be replaced with others. The same tactics are necessary in the case of treatment with calcium antagonists.

Diuretics are not used in pregnant women, as they reduce the BCC and prevent physiological fluid retention, which threatens the development of fetal hypoxia.

Beta blockers have a negative effect on the fetus, but at the same time, they do not have a teratogenic effect. They cause intrauterine growth retardation, the birth of a child with low body weight. But these drugs are used as a reserve therapy. The drug of choice is labetolol, which has internal sympathomimetic activity, that is, it additionally dilates blood vessels.

In pregnant women, preference is given to antihypertensive drugs of central action. These include clonidine and dopegit. Therefore, it is safe to say that dopegit can be used during pregnancy, it is the drug of choice.

If hypertension symptoms occur before the 34th week, then starting from the 22nd or 24th week, in parallel with preeclampsia therapy, prevention of fetal respiratory distress syndrome is carried out using dexamethasone or betaspan (beclomethasone). This is also an important stage of complex treatment. It is necessary to carry out all additional diagnostic methods during this period to determine the condition of the fetus - cardiotocography, Doppler scanning and ultrasound scanning with determination of uterine-placental circulation.

Dopegit and other drugs

There are situations in which the use of methyldopa is contraindicated or there is a need to combine several different drugs, then they come to the choice of another drug.

Regarding the use of beta-blockers with dopegit during pregnancy, there is an opinion that this is not a very successful combination, since beta-blockers exhibit their main effect in the form of a decrease in heart rate. And dopegit also has this effect, so hypotension can be so pronounced that a state of fetal hypoxia will occur, which threatens the development of various complications.

It is better to use methyldopa with nifedipine. It shows its effect in 40-60 minutes, which can be the initial stage of therapy, and then dopegit will show its effect, maintaining pressure throughout the day.

The use of dopegit with vasodilators (no-shpa, papaverine) also contributes to long-term hypotension, but the condition of the pregnant woman must be monitored, since significant edema may develop due to the concomitant expansion of arterioles and the deposition of blood in them.

Analogues of dopegit during pregnancy may be:

• clonidine (clofelline);
• nifedipine 10mg;
• Labetolol;
• magnesium sulfate.

These drugs are next in line after dopegit.

Dopegit during pregnancy is the drug of choice for the treatment of preeclampsia. Due to the proven absence of a negative effect on the fetus, it is successfully used to treat this pathology and shows good efficiency. But this drug should be prescribed only if there are strict indications, because despite the clinical effect, it still has its side effects. If signs of high blood pressure appear, such as headache, pain in the temples, nasal congestion, dizziness - a pregnant woman should consult a doctor, because timely treatment prevents the development of complications on the part of the child and on the part of the mother during childbirth. Dopegit should be prescribed only by a personal doctor, you should not rely on the advice of girlfriends, because not only your health is in your hands, but also the health and life of your future baby. The dosage of Dopegit is also individual and is selected by monitoring the woman's condition and blood pressure. Following all the doctor's recommendations, you will save the pregnancy.

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