Methyldopa Disulfiram

Nortriptyline may decrease hypotensive effects of centrally acting antihypertensive drugs, such as guanethidine, guanabenz, guanadrel, clonidine, methyldopa, and reser-pine. Concomitant use with disulfiram or ethchlorvynol may cause delirium and tachycardia. 

An isolated report describes a patient with hypertension, which was unresponsive to methyldopa in the presence of disulfiram. 

An alcoholic patient taking disulfiram did not respond to moderate to high doses of intravenous methyldopa, given to control his hypertension, but responded to oral low-dose clonidine. The suggested reason for this lack of response to methyldopa is that disulfiram blocks the activity of dopamine beta-hydroxylase, the enzyme responsible for the conversion of the methyldopa to its active form. The general importance of this apparent interaction is uncertain. 

McCord RW, LaCoite WS. Hypertension refractory to methyldopa in a disulfiram-treated patient. Ctin Res (1984) 32,923A. 

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