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Is It Safe to Use Methyldopa in Pregnancy?

By J. Beam
Updated May 17, 2024
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Methyldopa is a prescription drug used to treat hypertension, or high blood pressure, and carries an FDA pregnancy classification of B, which essentially means that using methyldopa in pregnancy is considered relatively safe. Hypertension during pregnancy is considered a somewhat common problem and in some cases, may need to be treated with medication for the duration of the gestational period. Many healthcare professionals prescribe methyldopa in pregnancy because it is considered safe and effective, but as with any drug, there is always a risk.

Methyldopa treats high blood pressure by relaxing blood vessels, allowing the blood to flow through the body easier, creating less stress on the heart. According to its FDA classification as a pregnancy class B drug, using methyldopa in pregnancy is considered relatively safe because controlled studies have indicated no evidence of risk to humans. It is important to note that a pregnancy class B drug indicates that the chances of harm are remote, but not impossible. While use in pregnancy classifications A and B are considered safe by most physicians, it is important for women who are pregnant or plan to become pregnant to discuss the risks and benefits of all drugs prescribed.

Some of the reasons a doctor may prescribe methyldopa in pregnancy include pregnancy-induced hypertension (PIH), gestational hypertension, or preeclampsia. Generally speaking, pregnancy-induced hypertension and gestational hypertension can be well-managed with a combination of lifestyle changes, diet and hypertension medication. Women who have mild to moderate hypertension before or during pregnancy, have a history of PIH, or are at risk for preeclampsia should definitely discuss the risks and benefits of using methyldopa in pregnancy.

Hypertension during pregnancy can present several risks factors, including increased risk of low birth weight, premature birth, placental abruption and increases the risk for developing hypertension later in life. Chronic hypertension, which is marked by high blood pressure prior to pregnancy or lasting more than 12 weeks post-partum, poses a higher risk during pregnancy and may lead to preeclampsia. Preeclampsia is a serious condition that poses a risk to both mother and baby.

Due to the risks hypertension can pose during pregnancy, routine prenatal visits are important to the health of both mother and baby. If high blood pressure is present, taking a prescription drug to lower blood pressure may pose a greater benefit than the risk of the drug itself. There are other blood pressure medications that are also considered safe, but the recommended use of methyldopa in pregnancy is considered one of the first choice prescription methods of controlling hypertension during pregnancy. Women who plan to breastfeed after delivery should talk to their doctor about their options for controlling blood pressure, including the risk of taking any drug, while breastfeeding.

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