From the Guidelines
Labetalol is a medication used primarily to treat high blood pressure (hypertension) and is particularly useful in situations where rapid blood pressure control is needed without excessive heart rate reduction, such as in pregnancy-related hypertension and hypertensive emergencies. It works as both an alpha and beta-blocker, meaning it blocks both alpha and beta adrenergic receptors in the body, which helps reduce blood pressure by decreasing heart rate, cardiac output, and peripheral vascular resistance 1.
Key Uses of Labetalol
- Hypertensive emergencies
- Pregnancy-related hypertension
- Situations where rapid blood pressure control is needed without excessive heart rate reduction
Administration and Dosage
- Typical oral dosing starts at 100mg twice daily, which can be gradually increased to 200-400mg twice daily as needed, with a maximum daily dose of 2400mg
- For hypertensive emergencies, labetalol can be administered intravenously, with a dose of 10-20 mg IV over 1-2 minutes, which may be repeated or doubled every 10 minutes to a maximum dose of 300 mg 1
Side Effects and Precautions
- Common side effects include dizziness, fatigue, nausea, and headache
- Labetalol should be used cautiously in patients with asthma, COPD, heart failure, or diabetes
- The medication should not be stopped abruptly as this can lead to rebound hypertension
- Blood pressure and heart rate should be monitored regularly while taking labetalol to ensure appropriate dosing and effectiveness
Recent Guidelines and Recommendations
- According to the 2019 guidelines from the European Heart Journal, labetalol is a first-line treatment for hypertensive emergencies, including malignant hypertension, hypertensive encephalopathy, and acute ischemic stroke 1
- The 2022 guidelines from the American Journal of Obstetrics and Gynecology recommend labetalol as a first-line treatment for severe hypertension in pregnancy, with a dose of 20,40, or 80 mg intravenously 1
From the FDA Drug Label
TRANDATE Tablets are indicated in the management of hypertension. TRANDATE Tablets may be used alone or in combination with other antihypertensive agents, especially thiazide and loop diuretics. The use of Labetalol (Normodyne, Trandate) is for the management of hypertension. It may be used alone or in combination with other antihypertensive agents.
- Key uses:
- Management of hypertension
- May be used with other antihypertensive agents, such as thiazide and loop diuretics 2
From the Research
Uses of Labetalol
Labetalol, also known as Normodyne or Trandate, is a medication with multiple uses, including:
- Treatment of angina pectoris, with or without hypertension 3
- Management of hypertensive crises, with the option to continue treatment with an oral preparation after initial intravenous administration 4
- Reduction of severe hypertension, with the ability to transition from intravenous to oral administration 5
- Treatment of essential hypertension, as a step II drug when added to hydrochlorothiazide 6
- Management of accelerated hypertension in emergency department patients, with oral doses of 100 to 300 mg 7
Key Benefits
The use of labetalol offers several benefits, including:
- Attenuation of increased coronary vascular resistance and improvement of coronary haemodynamics, especially under stress 3
- Prevention of arrhythmias generated by alpha-adrenoceptor stimulation 3
- Effective reduction of blood pressure, with a low risk of side effects at low doses 3, 4, 5, 6, 7
- Ability to be administered orally or intravenously, depending on the clinical situation 4, 5, 7
Dosage and Administration
The dosage and administration of labetalol vary depending on the specific use and clinical situation:
- For angina pectoris, the usual dosage is 200 mg twice daily, with a maximum dose of 1200 mg or more 3
- For hypertensive crises, an intravenous bolus of 100 mg can be followed by an infusion of 2-4 mg/min 4
- For essential hypertension, the initial dose is 100 mg twice daily, with titration to a maximum of 400 mg twice daily 6
- For accelerated hypertension, oral doses of 100 to 300 mg can be used 7