Labetalol

Labetalol

DrugLabetalol
Brand namesTrandate ®
IndicationsMycoardial ischemia.
Hypertension.
Hypertensive emergency, including in pregnancy.
Postoperative hypertension.
Mechanism of actionCombined beta-adrenergic and alpha-adrenergic blocker with rapid onset of action. Labetalol has less antihypertensive efficacy as compared with nicardipine. Labetalol is safe in patients with coronary artery disease since it does not increase heart rate, and reduces myocardial oxygen consumption.
Time to onset of action: 5 minutes.
EffectsLowers blood pressure, reduces heart rate, myocardial oxygen consumption and myocardial contractility.
Time to onset of action5 to 10 minutes
Duration of action2 to 4 hours
DeliveryIV
DoseCan be given as repeated intravenous bolus injections or as a constant-dose infusion.
Bolus regime:
• 20 mg IV bolus over 2 minutes, followed by 20 to 80 mg every 10 minutes to a total dose of 300 mg.
Infusion regime:
• 0.5–2 mg/minute IV infusion.
Higher doses are sometimes required.
Adverse effectsVomiting. Dizziness. Nausea. Atrioventricular blocks (AV-blocks). Orthostatic hypotension. Paresthesias (scalp tingling). Bronchospasm.
Caution• Avoided in hypertensive emergencies with left ventricular failure (due to negative inotropic effect).
• Used cautiously in patients with asthma (due to risk of bronchospasm).
• Used cautiously in bradycardia due to negative chronotropic effect.
• In patients with pheochromocytoma, cocaine or methamphetamine overdose, prior treatment with alpha blockade is necessary before administering labetalol (risk of elevating blood pressure in these settings).
Labetalol doses and administration in hypertension (hypertensive crisis/emergency).
Updated on 2025-01-18
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