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Labetalol (Trandate) ๐
Related Subjects: |Hypertension |Acute Heart Failure |Chronic Heart Failure
๐ Labetalol may be used for hypertension in pregnancy, aortic dissection, stroke thrombolysis, phaeochromocytoma, or other hypertensive emergencies. โ ๏ธ Always take senior/expert advice before IV use.
๐ About
Always check the BNF link here for updated dosing and monitoring advice.
- Mixed ฮฑ1- and ฮฒ-adrenergic blocker.
- ฮฑ-blockade โ peripheral vasodilation (โ afterload).
- ฮฒ-blockade โ reduces heart rate and myocardial oxygen demand.
โ๏ธ Mechanism of Action
- Blocks ฮฒ-receptors in heart, vessels, lungs, pancreas, and liver.
- Blocks ฮฑ1-receptors in vascular smooth muscle โ vasodilation and BP reduction.
- Maintains cardiac output better than pure ฮฒ-blockers in hypertensive crisis.
๐ฏ Hypertensive Emergency Targets
- ๐ช Aortic dissection: SBP < 110 mmHg (as tolerated).
- ๐ง Stroke thrombolysis: keep <185/110 mmHg before giving alteplase.
- ๐งฉ Hypertensive encephalopathy: aim SBP < 180 mmHg.
๐ Indications & Dosing
- ๐ฉธ Chronic hypertension: Labetalol (Trandate) 100โ200 mg PO twice daily with food (elderly: start 50 mg BD).
- ๐จ Hypertensive emergency: Labetalol (Trandate)
- IV bolus: 20 mg slow IV over 1 min (may repeat up to 50 mg).
- IV infusion: 0.5โ2 mg/min (max 120 mg/hr). Stop once BP target achieved.
- Max dose per course: 200 mg.
โ Contraindications
- Bradycardia (<60 bpm), systolic BP <100 mmHg.
- Asthma/bronchospasm ๐ซ.
- 2nd or 3rd-degree heart block.
- Uncontrolled / decompensated heart failure.
- Severe hypotension.
- Phaeochromocytoma (unless ฮฑ-blockade established).
- Sick sinus syndrome.
- Significant peripheral vascular disease ๐ฆต.
- โ ๏ธ Concomitant use with verapamil (risk of heart block/asystole).
- Caution in diabetes (masks hypoglycaemia, worsens control).
โ ๏ธ Side Effects
- Postural hypotension, dizziness, weakness.
- Headache, fatigue, cold peripheries ๐ฅถ.
- Bronchospasm.
- Worsening diabetic control.
- Nightmares, insomnia ๐.
- Worsening Raynaudโs, rash, vomiting.
๐ References
- BNF โ Labetalol
- ESC Hypertension Guidelines.
- Oxford Handbook of Clinical Medicine.
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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