text: Sexual dysfunction consisting of impaired erectile dysfunction or anorgasmia
  Hyperprolactinemia or excess prolactin, gynecomastia/breast enlargement in males, or amenorrhoea or absence of menstrual cycles in females
  Bradycardia or decreased heart rate
  Hypotension or decreased blood pressure (though this may also be considered a therapeutic benefit)
  Orthostatic hypotension (also known as postural hypotension)
  Hepatitis, hepatotoxicity, or liver dysfunction or damage
  Pancreatitis or inflammation of the pancreas
  Warm autoimmune hemolytic anemia or deficiency in red blood cells (RBCs)
  Myelotoxicity or bone marrow suppression, potentially leading to thrombocytopenia or blood platelet deficiency or leukopenia or white blood cell (WBC) deficiency
  Hypersensitivity such as lupus erythematosus, myocarditis, or pericarditis
  Lichenoid reactions such as skin lesions or rashes
  Pallor
  Rebound/withdrawal
  Rebound hypertension via withdrawal on account of tolerance upon the abrupt discontinuation of methyldopa has been reported.
  Mechanism of action
  The mechanism of action of methyldopa is not fully clear. Although it is a centrally acting sympathomimetic, it does not block reuptake or transporters. It may reduce the dopaminergic and serotonergic transmission in the peripheral nervous system and it indirectly affects norepinephrine (noradrenaline) synthesis. Methyldopa acts on alpha-2 adrenergic receptors, which are found on the pre synaptic nerve terminal. This inhibits the synthesis of norepinephrine by inhibiting tyrosine hydroxylase.