Labetalol

Alpha/Beta Blocker·Cardiovascular - Beta Blockers

Hypertension in pregnancy (pre-eclampsia), hypertensive emergencies

PBSBETA BLOCKERTrandate100 mg tabletS4+1

Max Dose

2400 mg/day

Half-life

5–8 h

Pregnancy

SAFE

Hepatic

MONITOR

Rapid Summary

Overview

Combined non-selective beta and alpha-1 blocker. Its primary modern utility is the management of hypertension in pregnancy and hypertensive emergencies.

Maximum Dose

Max 2400 mg/day (in severe refractory cases, usually in divided doses).

Clinical Focus

Safe in pregnancy. IV formulation acts rapidly for hypertensive emergencies but requires strict continuous monitoring.

Bottom Line

Labetalol is the first-line IV and oral antihypertensive in pregnancy and hypertensive emergencies, but causes significant orthostatic hypotension and must never be used in asthma.

Formulation & Access

Brand Names

Trandate

Oral Routes

Tablets (100 mg, 200 mg).

Parenteral

Ampoule (50 mg/10 mL) for IV injection/infusion.

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

Hypertension in pregnancy (pre-eclampsia), hypertensive emergencies.

Clinical Place

First-line oral/IV agent in obstetrics. Replaces other beta-blockers when alpha-vasodilation is also desired.

Quick reference

Class & Role

Alpha/Beta Blocker — Combined non-selective beta and alpha-1 blocker.

Route / Formulation

Tablets (100 mg, 200 mg). (Trandate)

Usual Dose & Max

PO 100-200 mg BD. Titrate up rapidly if needed. Max 2400 mg/day (usually divided TDS/QID at high doses).

Key Indication Doses

Pregnancy HTN (Oral): PO 100-200 mg BD. Titrate up rapidly if needed. Max 2400 mg/day (usually divided TDS/QID at high doses). Hypertensive Emergency: IV 20 mg over about 2 mins; may give 40 mg then up to three further 80 mg boluses every 10-20 mins if required. Infusion in severe hypertension in pregnancy: start 20 mg/hr and increase by 20 mg/hr every 20 mins to max 160 mg/hr. Elderly / Frail: Start at PO 50 mg BD due to significant orthostatic hypotension risk.

Best Uses

Labetalol is the first-line IV and oral antihypertensive in pregnancy and hypertensive emergencies, but causes significant orthostatic hypotension and must never be used in asthma.

Avoid / Cautions

Asthma/COPD, 2nd/3rd degree heart block, severe bradycardia. Pregnancy Category C, but extensive historical data confirms safety for maternal HTN.

Key Risks

Cardiovascular: Orthostatic hypotension, bradycardia. Hepatic: Rare but severe hepatocellular injury (reversible on cessation). Respiratory: Bronchospasm in susceptible individuals.

Key Interactions

Additive hypotension with halothane/anaesthetics. Bradycardia with non-DHP CCBs.

Monitoring

Continuous BP and ECG monitoring during IV administration. Monitor for postural drops with oral dosing. Baseline and routine LFTs (stop drug if jaundice or significant transaminitis occurs).

Clinical Pearl

Labetalol frequently causes a harmless but intensely annoying tingling or formication of the scalp (the 'labetalol tingle'). Reassure the patient.

Access

Trandate100 mg tablet

Brand: Trandate
Formulation: Tablets (100 mg, 200 mg)

Labetalol

Alpha/Beta Blocker·Cardiovascular - Beta Blockers

Hypertension in pregnancy (pre-eclampsia), hypertensive emergencies

PBSBETA BLOCKERTrandate100 mg tabletS4+1

Max Dose

2400 mg/day

Half-life

5–8 h

Pregnancy

SAFE

Hepatic

MONITOR

Rapid Summary

Overview

Combined non-selective beta and alpha-1 blocker. Its primary modern utility is the management of hypertension in pregnancy and hypertensive emergencies.

Maximum Dose

Max 2400 mg/day (in severe refractory cases, usually in divided doses).

Clinical Focus

Safe in pregnancy. IV formulation acts rapidly for hypertensive emergencies but requires strict continuous monitoring.

Bottom Line

Labetalol is the first-line IV and oral antihypertensive in pregnancy and hypertensive emergencies, but causes significant orthostatic hypotension and must never be used in asthma.

Formulation & Access

Brand Names

Trandate

Oral Routes

Tablets (100 mg, 200 mg).

Parenteral

Ampoule (50 mg/10 mL) for IV injection/infusion.

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

Hypertension in pregnancy (pre-eclampsia), hypertensive emergencies.

Clinical Place

First-line oral/IV agent in obstetrics. Replaces other beta-blockers when alpha-vasodilation is also desired.

Quick reference

Class & Role

Alpha/Beta Blocker — Combined non-selective beta and alpha-1 blocker.

Route / Formulation

Tablets (100 mg, 200 mg). (Trandate)

Usual Dose & Max

PO 100-200 mg BD. Titrate up rapidly if needed. Max 2400 mg/day (usually divided TDS/QID at high doses).

Key Indication Doses

Best Uses

Labetalol is the first-line IV and oral antihypertensive in pregnancy and hypertensive emergencies, but causes significant orthostatic hypotension and must never be used in asthma.

Avoid / Cautions

Asthma/COPD, 2nd/3rd degree heart block, severe bradycardia. Pregnancy Category C, but extensive historical data confirms safety for maternal HTN.

Key Risks

Cardiovascular: Orthostatic hypotension, bradycardia. Hepatic: Rare but severe hepatocellular injury (reversible on cessation). Respiratory: Bronchospasm in susceptible individuals.

Key Interactions

Additive hypotension with halothane/anaesthetics. Bradycardia with non-DHP CCBs.

Monitoring

Continuous BP and ECG monitoring during IV administration. Monitor for postural drops with oral dosing. Baseline and routine LFTs (stop drug if jaundice or significant transaminitis occurs).

Clinical Pearl

Labetalol frequently causes a harmless but intensely annoying tingling or formication of the scalp (the 'labetalol tingle'). Reassure the patient.

Access

Trandate100 mg tablet

Brand: Trandate
Formulation: Tablets (100 mg, 200 mg)