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(Date of issue: June 2015, Version: 1)

This is a UKTIS monograph for use by health care professionals. For case-specific advice please contact UKTIS on 0344 892 0909. To report an exposure please download and complete a pregnancy reporting form. Please encourage all women to complete an online reporting form.

A corresponding patient information leaflet on methyldopa use in pregnancy is available at


Methyldopa is an antihypertensive agent thought to act by stimulating α2-adrenergic receptors. Methyldopa may be indicated in the treatment of hypertension or gestational hypertension.

NICE guidelines identify labetalol as the preferred antihypertensive for use during pregnancy. Alternative treatments for chronic or gestational hypertension include methyldopa and nifedipine, and the final choice will depend on the side-effect profile for both the pregnant woman and the fetus/neonate. If a woman with pre-existing hypertension has been prescribed methyldopa during pregnancy, NICE recommend that it is discontinued within two days of delivery and that the antihypertensive treatment the woman was taking before pregnancy is resumed.

The available studies are inadequate to quantify the risk of congenital malformation or spontaneous abortion following use of methyldopa in the first trimester. Specific risks for Ebstein’s anomaly, and digestive, genital and urinary tract defects have been reported in single studies but have not been replicated and further analyses are needed to confirm or refute these associations. The available data, although still limited,  do not suggest increased risks of preterm delivery, low birth weight, small for gestational age, intrauterine death, neonatal complications or adverse neurodevelopmental outcomes with methyldopa exposure when compared to other antihypertensives or untreated hypertension. A single meta-analysis provided evidence that treatment of hypertension in pregnancy may offer protection against fetal/neonatal death.

Exposure to methyldopa at any stage in pregnancy would not usually be regarded as medical grounds for termination of pregnancy or any additional fetal monitoring. However, other risk factors may be present in individual cases which may independently increase the risk of adverse pregnancy outcome. Clinicians are reminded of the importance of consideration of such factors when performing case-specific risk assessments.

This document is regularly reviewed and updated. Only use full UKTIS monographs downloaded directly from to be sure you are using the most up-to-date version. The summaries of these monographs are openly available on

This is a summary of the full UKTIS monograph for health care professionals and should not be used in isolation. The full UKTIS monograph and access to any hyperlinked related documents is available to health care professionals at

If you have a patient with exposure to a drug or chemical and require assistance in making a patient-specific risk assessment, please telephone UKTIS on 0344 892 0909 to discuss the case with a teratology specialist.

If you would like to report a pregnancy to UKTIS please click here to download our pregnancy reporting form. Please encourage all women to complete an online reporting form.

Disclaimer: Every effort has been made to ensure that this monograph was accurate and up-to-date at the time of writing, however it cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes of the measures recommended. The final decision regarding which treatment is used for an individual patient remains the clinical responsibility of the prescriber. This material may be freely reproduced for education and not for profit purposes within the UK National Health Service, however no linking to this website or reproduction by or for commercial organisations is permitted without the express written permission of this service. This document is regularly reviewed and updated. Only use UKTIS monographs downloaded directly from or to ensure you are using the most up-to-date version.