Labetalol

General

• Type: Beta blockers
• Dosage Forms:
• Common Trade Names:

Adult Dosing

• Bolus dosing
  • 20mg IV followed by 40-80mg q10min up to total of 300mg
• Infusion dosing
  • 0.5-2mg/min

Intracranial hemorrhage

• Start with labetalol 20mg over 1-2 minutes
  • Then, 20mg q3-5 mins until target blood pressure is achieved
  • Then, start an infusion of 1-8mg/min

Special Populations

• Pregnancy Rating: C
• Lactation: Compatible with breastfeeding
• Renal Dosing
  • Adult
    • No renal dosing adjustments necessary. Drug not removed with hemodialysis
  • Pediatric
    • No renal dosing adjustments necessary. Drug not removed with hemodialysis
• Hepatic Dosing
  • Adult
    • May need reduced dosing given decreased metabolism and increased oral bioavailability with hepatic impairment however no specific dosing adjustments in manufacturer labeling. Use caution.
  • Pediatric
    • May need reduced dosing given decreased metabolism and increased oral bioavailability with hepatic impairment however no specific dosing adjustments in manufacturer labeling. Use caution.

Indications

• hypertension in setting of myocardial ischemia
• hypertension in setting of neurologic injury
• hypertension in setting of preeclampsia/eclampsia

Contraindications

• Allergy to class/drug

Adverse Reactions

• Orthostatic hypotension

Pharmacology

• Half-life: 5-8hrs
• Metabolism: Hepatic via conjugation
• Excretion: Renal 55-60%
• Mechanism of Action:
  • Class II - Nonselective β-blocker
  • α₁-blocker
• Onset of action = 2-5min (IV)
• Duration of action = 2-4hr (IV)

Indications by Condition

The following table is automatically generated from disease/condition pages across WikEM.

Indication	Dose	Context	Route	Population
Hypertensive emergency	20 mg IV bolus, double q10 min (max 300 mg) or 0.5-2 mg/min drip	1st line antihypertensive	IV	Adult
Intracranial hemorrhage (main)	20 mg IV bolus, repeat q3-5 min; then 1-8 mg/min drip	BP control in ICH	IV	Adult
Nontraumatic thoracic aortic dissection	20mg bolus, then 40-80mg q10min (max 300mg) or 1-2mg/min drip	Heart rate and blood pressure control	IV	Adult
Stroke (main)	10-20 mg IV push, may repeat x1	BP control in acute stroke	IV	Adult
Traumatic intracerebral hemorrhage	20 mg IV bolus, repeat q3-5 min; then 1-8 mg/min drip	BP control in ICH	IV	Adult

See Also

• Beta-blockers
• Beta-blocker toxicity
• Antiarrhythmics
• Antihypertensive medications

References

Labetalol: Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019.