Labetalol
TRANDATE
What it isCombined alpha-1 and non-selective beta blocker; hypertensive emergency and hypertension in pregnancy.
Why this oneIV titratability plus a pregnancy safety record make it a standard parenteral option in preeclampsia.
What limits itOrthostatic hypotension, and the beta blockade limits it in asthma. Hepatotoxicity is rare but reported.
FDA-approved for
- hypertension (1984)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Hypertension | adult | 100 mg BID | 200-400 mg BID | 1,200-2,400 mg/day (severe hypertension) |
Titration After 2-3 days, may titrate in 100 mg BID increments every 2-3 days (increments not to exceed 200 mg BID)
Renal Undefined
Hepatic Undefined
Instructions
- Dosage must be individualized; may split total daily dose to TID to improve tolerability
- Additive effect when a diuretic is added—may require dose adjustment
Contraindications
- Bronchial asthma / history of obstructive airway disease
- Overt cardiac failure
- Greater-than-first-degree heart block
- Cardiogenic shock
- Severe bradycardia; other conditions with severe/prolonged hypotension
Cautions
- Hepatotoxicity (rare, some fatal)
- Exacerbation of ischemic heart disease on abrupt withdrawal
- Bronchospasm
- Heart failure/bradycardia
- Masking of hypoglycemia/thyrotoxicosis
- Orthostatic hypotension
Adverse reactions
- Dizziness
- Fatigue
- Nausea
- Nasal congestion
- Headache
Pregnancy Pregnancy Category C; use only if potential benefit justifies potential fetal risk
Lactation Undefined
NO BOXED WARNINGS
Principal riskOrthostatic hypotension; the preferred agent in pregnancy
Cost, est. cash$5–$150/month
Generic entry1998
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityBradycardia, hypotension and bronchospasm; overdose may cause conduction block or cardiogenic shock.
Mechanism of action: Labetalol ballicule
Open Labetalol in the interactive console ↗
Memory aids: mascots and interaction avatars
LOL hat → beta blocker
