-
Blood Pressure Management in Pregnancy
-
Refractory Hypertension
- Effective outpatient agent in oral form patients with Refractory Hypertension
-
Hypertensive Emergency
- Labetalol is a preferred agent when compared with Hydaralazine and Clonidine
-
Nicardipine and Clevidipine have replaced intravenous Labetalol for Hypertensive Emergency
- Labetalol is difficult to achieve Blood Pressure control in Hypertensive Crisis despite titration
- Labetalol is short acting
- Not lipophilic
- Hepatic metabolism
-
Bioavailability 20 to 40%
- Well absorbed but high first-pass hepatic metabolism
- Bioavailability increased when taken with food
- Not Cardioselective
- Primary activity is as a negative inotrope
- Chronotropic effect is mild
- Combination of classes (similar to Carvedilol)
- Lowers Blood Pressure without reflex Tachycardia
- Nonselective Beta Blocker (7 fold more beta than alpha activity)
- Binds vascular (and Bronchial) Smooth Muscle beta receptors
- Decreases Heart Rate, Cardiac Output and Blood Pressure
- Selective Alpha-1 Adrenergic Antagonist (weak compared with beta activity)
- Competitively binds vascular Smooth Muscle alpha-1 Adrenergic Receptors
- Blocks peripheral blood vessel Vasoconstriction
- Adjust dose in liver and renal Impairment
- Oral
- Start: 100 mg orally twice daily
- May be divided three times daily if causes Nausea or Dizziness
- Target: 200 to 600 mg orally twice daily
- Maximum: 2400 mg/day
- Intravenous Injection
- Start: 20 mg slow IV injection
- Next: 40-80 mg every 10 minutes as needed
- Cummulative Maximum: 200-300 mg
- Intravenous Infusion
- Start 0.5 to 2 mg/min IV up to cummulative maximum of 200-300 mg
- Dosing
-
Children (Not FDA approved)
- Oral
- Start: 4 mg/kg/day orally divided twice daily
- Maximum: 40 mg/kg/day up to adult maximum of 2400 mg
- Intravenous Infusion
- Dose: 0.3 to 1 mg/kg/dose up to 20 mg slow IV injection up to every 10 minutes
- Cummulative Maximum: 200-300 mg
- Intravenous Infusion
- Start 0.4 to 1 mg/kg/hour IV up to 3 mg/kg/hour
- Systemic Beta Agonists
- Labetalol blocks bronchodilation
- Pregnancy Category C
- Safe in Lactation
- (2019) Presc Lett, Resource #350503, Comparison of Oral Beta Blockers
- Olson (2020) Clinical Pharmacology, MedMaster, Miami, p. 66
- Hamilton (2020) Tarascon Pocket Pharmacopeia, Jones and Bartlett, accessed on IOS, 4/9/2021
loading