Drug Index


Mechanism :

Labetalol combines both selective, competitive, alpha1-adrenergic blocking and nonselective, competitive, beta-adrenergic blocking activity in a single substance.

Indication :

  • Hypertension (off-label)
  • Hypertensive crisis

Contraindications :

Labetalol is contraindicated in cardiogenic shock, sinus bradycardia and greater than first degree block, bronchial asthma, congestive heart failure unless the failure is secondary to a tachyarrhythmia treatable with Labetalol.

Dosing :

Hypertensive crisis:
0.4-1 mg/kg/hour by continuous intravenous infusion; Max: 3 mg/kg/hour.
1-3 mg/kg/day given orally in two divided doses OR 0.3-1 mg/kg intermittently as an intravenous injection; Max: 1.2 g/day.

Adverse Effect :

Bradycardia, intermittent claudication, Raynaud’s phenomena, postural hypotension, precipitation of heart block, thrombocytopenia, hypoglycemia, confusion, hallucinations, dizziness, paraesthesia, mood changes, nightmares and tingling sensation of scalp. Respiratory effects are bronchospasm.

Interaction :

Calcium Channel Blockers: Additive effect.
Prostaglandin Synthase inhibiting drugs: Decrease the hypotensive effects of beta blockers.
Catecholamine-depleting drugs such as reserpine: Hypotension, marked bradycardia, vertigo, syncopal attacks, or orthostatic hypotension.
Haloperidol: Hypotension and cardiac arrest.
Theophylline: Clearance is reduced.
Cimetidine: Increasing blood levels.
Chlorpromazine: Increased plasma levels of both drugs.
Phenytoin, Phenobarbitone and Rifampin: Accelerate labetalol clearance.
Ethanol: Slows the rate of absorption of labetalol.
Aluminium Hydroxide Gel: Greatly reduces intestinal absorption of labetalol.

Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50Dose as in normal renal function
10-20Dose as in normal renal function
<10Dose as in normal renal function

Dose in Patients undergoing Renal Replacement Therapies
CAPDNot dialysed. Dose as in normal renal function
HDNot dialysed. Dose as in normal renal function
HDF/High fluxUnknown dialysability. Dose as in normal renal function
CAV/VVHDProbably not dialysed. Dose as in normal renal function

Hepatic Dose :

Hepatic impairment: Reduce dose by 50%
03/21/2024 01:24:11 Labetalol
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