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Labetalol

    Brands

    DEA Class;  Rx

    Common Brand Names; Trandate

    •  Beta-Blockers, Alpha Activity

    Oral and parenteral combined selective alpha1-blocker and nonselective beta-blocker
    Used for hypertension
    Orthostatic hypotension common after intravenous use

    Indicated for the treatment of hypertension.

    For the treatment of dysautonomia† due to tetanus.
    For the treatment of hypertensive crisis (e.g., hypertensive urgency or hypertensive emergency).

    Asthma or obstructive airway disease, severe bradycardia, 2°/3° heart block (without pacemaker), cardiogenic shock, bronchial asthma, uncompensated cardiac failure, hypersensitivity, sinus bradycardia, sick sinus syndrome without permanent pacemaker; conditions associated with prolonged and severe hypotension

    • Dizziness (1-20%)
    • Lightheadedness (1-20%)
    • Nausea (≤19%)
    • Tingling sensation of scalp (4-12%)
    • Fatigue (1-11%)
    • Elevated serum blood urea nitrogen (BUN) (≤8%)
    • Elevated serum creatinine (8%)
    • Congestion of nasal sinus (1-6%)
    • Orthostatic hypotension (1-5%)
    • Absence of ejaculation (<5%)
    • Paresthesia (<5%)
    • Elevated liver enzymes (4%)
    • Diaphoresis (≤4%)
    • Edema (≤2%)
    • Bronchospasm (1-2%)
    • Dyspnea (1-2%)
    • Pruritus (1%)
    • Rash (1%)
    • Altered taste sense (1%)
    • Ventricular arrhythmia (1%; IV)

    Use with caution in anesthesia or surgery (myocardial depression), bronchospastic disease (not recommended), cerebrovascular insufficiency, diabetes mellitus, hyperthyroidism or thyrotoxicosis, hepatic impairment, renal impairment, peripheral vascular disease, compromised left ventricular function, advanced age, heart failure, pheochromocytoma

    Increased risk of stroke after surgery

    Severe hepatic injury reported with use; with prolonged use, monitor liver function tests

    Sudden discontinuance can exacerbate angina and lead to myocardial infarction

    Use with caution in patients taking calcium channel blockers, cardiac glycosides, or inhaled anesthetics

    Intraoperative floppy iris syndrome observed during cataract surgery in some patients treated with alpha1 blockers (labetalol is both an alpha and a beta blocker)

    Hypotension with or without syncope may occur; monitor

    Consider pre-existing conditions, such as, sick sinus syndrome before initiating therapy

    Use caution in patients with history of severe anaphylaxis to allergens; patients taking beta-blockers may become more sensitive to repeated challenges; treatment with epinephrine in patients taking beta-blockers may be ineffective or promote undesirable effects

    Use with caution in patients with myasthenia gravis, psoriasis, or psychiatric illness (may cause or exacerbate CNS depression)

    Pregnancy category: C

    Lactation: Small amounts excreted; use with caution

    Adults

    2,400 mg/day PO; 300 mg/day IV.

    Geriatric

    2,400 mg/day PO; 300 mg/day IV.

    Adolescents

    1 mg/kg/dose (Max: 40 mg/dose) IV and 3 mg/kg/hour continuous IV infusion have been used off-label for the treatment of hypertension.

    Children

    1 mg/kg/dose (Max: 40 mg/dose) IV and 3 mg/kg/hour continuous IV infusion have been used off-label for the treatment of hypertension.

    Infants

    Safety and efficacy have not been established.

    Neonates

    Safety and efficacy have not been established.

    Labetalol hydrochloride

    injectable solution

    • 5mg/mL

    tablet

    • 100mg
    • 200mg
    • 300mg