Labetalol Dosing for Blood Pressure Control
The initial oral dose of labetalol for blood pressure control is 200 mg twice daily, with a maximum daily dose of 2400 mg in divided doses. 1
Oral Labetalol Dosing Schedule
- Initial dose: 200 mg twice daily 1
- Titration: Dose can be increased gradually based on blood pressure response
- Maintenance dose: 200-600 mg twice daily 1
- Maximum daily dose: 2400 mg in divided doses 1, 2
Inpatient Titration Schedule
For patients requiring dose adjustments while hospitalized, the following schedule can be followed 3:
| Regimen | Total Daily Dose |
|---|---|
| 200 mg twice daily | 400 mg |
| 400 mg twice daily | 800 mg |
| 800 mg twice daily | 1600 mg |
| 1200 mg twice daily | 2400 mg |
The dosage may be increased at 1-day intervals while in the hospital to achieve the desired blood pressure reduction 3.
Intravenous Labetalol Dosing
For acute blood pressure control in emergency settings:
- Initial IV dose: 10-20 mg over 1-2 minutes 2
- Subsequent dosing: May repeat or double every 10 minutes 2
- Maximum IV dose: 300 mg total 2, 3
Special Considerations
- Contraindications: Avoid in patients with bradycardia, bronchospasm, or decompensated heart failure 2
- Monitoring: Blood pressure should be monitored during and after administration to avoid excessive drops 3
- Elderly patients: Consider using lower doses and careful titration 1
- Pregnancy: Labetalol is considered safe for use in pregnancy and is listed as a first-line agent for hypertension management in pregnant patients 2
Precautions
- Avoid rapid or excessive falls in blood pressure
- Monitor for orthostatic hypotension, especially when initiating therapy
- For patients with severe hypertension, the transition from IV to oral therapy typically begins with 200 mg orally, followed by another 200-400 mg dose 6-12 hours later 3, 4
Labetalol's combined alpha and beta-blocking properties make it particularly useful for hypertension management, with a relatively low incidence of reflex tachycardia compared to pure vasodilators 5.