From the FDA Drug Label
Exacerbation of Ischemic Heart Disease Following Abrupt Withdrawal: Angina pectoris has not been reported upon labetalol HCl discontinuation. However, hypersensitivity to catecholamines has been observed in patients withdrawn from beta-blocker therapy; exacerbation of angina and, in some cases, myocardial infarction have occurred after abrupt discontinuation of such therapy When discontinuing chronically administered TRANDATE Tablets, particularly in patients with ischemic heart disease, the dosage should be gradually reduced over a period of 1 to 2 weeks and the patient should be carefully monitored Patients should be warned against interruption or discontinuation of therapy without the physician's advice Because coronary artery disease is common and may be unrecognized, it may be prudent not to discontinue therapy with TRANDATE Tablets abruptly in patients being treated for hypertension.
Labetalol should not be stopped abruptly without a tapering process, especially in patients with ischemic heart disease. The dosage should be gradually reduced over a period of 1 to 2 weeks and the patient should be carefully monitored 1.
From the Research
No, labetalol should not be stopped abruptly without a tapering process. Abrupt discontinuation of beta-blockers like labetalol can lead to a withdrawal syndrome characterized by increased heart rate, elevated blood pressure, worsening angina, and in severe cases, heart attacks or life-threatening arrhythmias. When discontinuing labetalol, a gradual tapering schedule over 1-2 weeks is typically recommended, with the dose being reduced by about 50% every 3-7 days while monitoring blood pressure and heart rate. The exact tapering schedule should be determined by a healthcare provider based on the patient's specific condition, current dose, and duration of treatment. This gradual withdrawal is necessary because long-term beta-blocker use causes physiological adaptations, including upregulation of beta-receptors, making the body hypersensitive to adrenaline and noradrenaline when the medication is suddenly removed. Patients with underlying cardiovascular conditions such as coronary artery disease, hypertension, or arrhythmias are at particularly high risk for adverse events with abrupt discontinuation 2.
Some key points to consider when stopping labetalol include:
- The risk of withdrawal syndrome and its potential consequences, such as increased heart rate and blood pressure, which can be severe in patients with underlying cardiovascular conditions 3, 4
- The importance of gradual tapering to minimize the risk of adverse events, with a recommended tapering schedule of 1-2 weeks 2
- The need for close monitoring of blood pressure and heart rate during the tapering process to adjust the schedule as needed
- The potential for individual variation in response to labetalol discontinuation, emphasizing the importance of personalized care and monitoring 5, 6
It is essential to prioritize the patient's safety and well-being when discontinuing labetalol, and a healthcare provider should be consulted to determine the best approach for each individual patient.