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labetalol

Pronunciation

Generic Name: labetalol (la BAY ta lol)
Brand Name: Trandate, Normodyne

What is labetalol?

Labetalol is a beta-blocker that affects the heart and circulation (blood flow through arteries and veins).

Labetalol is used to treat hypertension (high blood pressure).

Labetalol may also be used for purposes not listed in this medication guide.

What is the most important information I should know about labetalol?

You should not use labetalol if you have asthma or COPD, very low blood pressure, or a serious heart condition such as second or third degree heart block, severe heart failure, or very slow heartbeats.

What should I discuss with my healthcare provider before taking labetalol?

You should not take labetalol if you are allergic to it, or if you have:

  • asthma or chronic obstructive pulmonary disease (COPD);

  • a serious heart condition such as second or third degree heart block, severe heart failure, or very slow heartbeats; or

  • a condition that causes very low blood pressure.

To make sure labetalol is safe for you, tell your doctor if you have:

  • liver disease;

  • kidney disease;

  • pheochromocytoma (tumor of the adrenal gland);

  • congestive heart failure;

  • diabetes; or

  • allergies.

Labetalol can affect your pupils during cataract surgery. Tell your eye surgeon ahead of time that you are using this medicine.

It is not known whether labetalol will harm an unborn baby. Labetalol may cause heart or lung problems in a newborn if the mother takes the medication during pregnancy. Tell your doctor if you are pregnant or plan to become pregnant while taking labetalol.

Labetalol can pass into breast milk in small amounts. Tell your doctor if you are breast-feeding.

Labetalol is not approved for use by anyone younger than 18 years old.

How should I take labetalol?

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Your blood pressure will need to be checked often, and you may need frequent medical tests at your doctor's office.

If you need surgery, tell the surgeon ahead of time that you are using labetalol.

Do not skip doses or stop taking labetalol without first talking to your doctor. Stopping suddenly may make your condition worse.

Labetalol can cause false results with certain lab tests of the urine. Tell any doctor who treats you that you are using labetalol.

Taking labetalol can make it harder for you to tell when your blood sugar is low. If you have diabetes, check your blood sugar regularly.

Keep using this medicine as directed, even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life.

Store at room temperature away from moisture and heat.

Labetalol is only part of a complete program of treatment for hypertension that may also include diet, exercise, weight control, and other medications. Follow your diet, medication, and exercise routines very closely.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if your next dose is less than 8 hours away. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include slow heart rate, extreme dizziness, or fainting.

What should I avoid while taking labetalol?

Labetalol may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Drinking alcohol can further lower your blood pressure and may increase certain side effects of labetalol.

Labetalol side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • a light-headed feeling, like you might pass out;

  • slow heart rate, weak pulse, fainting, slow breathing (breathing may stop);

  • shortness of breath (even with mild exertion), swelling, rapid weight gain;

  • liver problems--nausea, upper stomach pain, itching, tiredness, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or

  • dangerously high blood pressure--severe headache, blurred vision, pounding in your neck or ears, nosebleed, anxiety, confusion, severe chest pain, shortness of breath, irregular heartbeats.

Common side effects may include:

  • dizziness;

  • nausea, upset stomach;

  • stuffy nose; or

  • tingly feeling in your scalp.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Labetalol dosing information

Usual Adult Dose for Hypertension:

ORAL:
Initial dose: 100 mg orally 2 times a day (alone or added to a diuretic regimen)
Titration: Dosage may be increased in increments of 100 mg orally 2 times a day every 2 or 3 days
Maintenance dose: 200 to 400 mg orally 2 times a day
Maximum dose: Some patients may require 1200 to 2400 mg orally per day (titration increments should not exceed 200 mg orally 2 times a day)

PARENTERAL:
REPEATED IV INJECTION:
-Immediately before the injection and at 5 and 10 minutes after injection, supine blood pressure should be measured to evaluate response.
-Initial dose: 20 mg by slow IV injection over a 2-minute period
-Additional injections of 40 to 80 mg can be given at 10 minute intervals until a desired supine blood pressure is achieved or a total of 300 mg has been used
-The maximum effect usually occurs within 5 minutes of each injection
SLOW CONTINUOUS IV INFUSION:
-The solution for injection should be prepared according to the manufacturer suggested guidelines for a resultant solution of 1 mg/mL or 2 mg/3 mL:
-For 1 mg/mL, the diluted solution should be administered at a rate of 2 mL/min to deliver 2 mg/min.
-For 2 mg/3 mL, the diluted solution should be administered at a rate of 3 mL/min to deliver approximately 2 mg/min.
-Rate of infusion: The rate of infusion of the diluted solution may be adjusted according to the blood pressure response, at the discretion of the physician. To facilitate a desired rate of infusion, the diluted solution can be infused using a controlled administration mechanism, (e.g., graduated burette or mechanically driven infusion pump).
-Since the half-life of this drug is 5 to 8 hours, steady-state blood levels (in the face of a constant rate of infusion) would not be reached during the usual infusion time period; the infusion should be continued until a satisfactory response is obtained and should then be stopped and the oral formulation should be started.
-The effective IV dose is usually in the range of 50 to 200 mg.
-A total dose of up to 300 mg IV may be required in some patients.

Comments:
-The injection solution is intended for IV use in hospitalized patients.
-Patients should always be kept in a supine position during the period of IV drug administration. A substantial fall in blood pressure on standing should be expected in these patients.
-Blood pressure should be monitored during and after completion of the infusion or IV injections.

Initiation of Dosing with Labetalol Hydrochloride Tablets After Repeated IV Injections or Slow IV Injection:
-Subsequent oral dosing with the tablet formulation should begin when it has been established that the supine diastolic blood pressure has begun to rise.
-The recommended initial dose is 200 mg orally, followed in 6 to 12 hours by an additional dose of 200 or 400 mg orally, depending on the blood pressure response.
-Thereafter, inpatient titration with labetalol hydrochloride tablets may proceed as follows:
Day 1: 400 mg orally in 2 to 3 divided doses
Day 2: 800 mg orally in 2 to 3 divided doses
Day 3: 1600 mg orally in 2 to 3 divided doses
Day 4: 2400 mg orally in 2 to 3 divided doses

Comment:
-While in the hospital, the dosage of the tablets may be increased at 1 day intervals to achieve the desired blood pressure reduction.

Use: For control of blood pressure in severe hypertension

What other drugs will affect labetalol?

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • cimetidine;

  • nitroglycerin;

  • insulin or oral diabetes medicine;

  • an antidepressant--amitriptyline, doxepin, desipramine, imipramine, nortriptyline, and others;

  • a bronchodilator--albuterol, formoterol, salmeterol; or

  • heart or blood pressure medicine--amlodipine, digitalis, digoxin, verapamil.

This list is not complete. Other drugs may interact with labetalol, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about labetalol.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 10.01.

Date modified: November 30, 2016
Last reviewed: May 06, 2016

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