Dangerous Drug: Labetalol Hydrochloride(la bet’ a lol)
Trandate
PREGNANCY CATEGORY C
Drug Classes
Alpha- and beta-adrenergic blocker
Antihypertensive
Therapeutic Actions
Competitively blocks alpha1– and beta1– and beta2-adrenergic receptors, and has some sympathomimetic activity at beta2-receptors. Alpha- and beta-blocking actions contribute to the BP-lowering effect; beta blockade prevents the reflex tachycardia seen with most alpha-blocking drugs and decreases plasma renin activity.
Indications
Hypertension, alone or with other oral drugs, especially diuretics
Parenteral preparations: Severe hypertension
Unlabeled uses: Control of BP in pheochromocytoma; clonidine withdrawal hypertension
Contraindications and Cautions
Contraindicated with sinus bradycardia, second- or third-degree heart block, cardiogenic shock, heart failure, asthma.
Use cautiously with diabetes or hypoglycemia (can mask cardiac signs of hypoglycemia), nonallergic bronchospasm (oral drug—IV is absolutely contraindicated), pheochromocytoma (paradoxic increases in BP have occurred), hepatic impairment, pregnancy, lactation.
Available Forms
Tablets—100, 200, 300 mg; injection—5 mg/mL
Dosages
Adults
Oral
Initial dose, 100 mg PO bid. After 2–3 days, using standing BP as indicator, adjust dosage in increments of 100 mg PO bid every 2–3 days. For maintenance, 200–400 mg bid. May need up to 2,400 mg/day; to improve tolerance, divide total daily dose and give tid.
Parenteral
Severe hypertension: For repeated IV injection, 20 mg (0.25 mg/kg) slowly over 2 min. Individualize dosage using supine BP; additional doses of 40 or 80 mg can be given at 10-min intervals until desired BP is achieved or until a 300-mg dose has been injected. For continuous IV infusion, dilute ampule (see IV Lines), infuse at a rate of up to 2 mg/min, adjust according to BP response up to 300 mg total dose. Transfer to oral therapy as soon as possible.
Pediatric patients
Safety and efficacy not established.
Geriatric patients
Generally require lower maintenance doses between 100 and 200 mg bid.
