Labetalol is a beta-blocker used to treat high blood pressure and is given alone or in combination with diuretics. The mechanism of action of labetalol is to widen the blood vessels and slow the heartbeat in order to lower blood pressure.
Like other beta-blockers, the drug may worsen signs of congestive heart failure (CHF - congestive heart failure) and may mask low blood sugar and exacerbate asthma. Labetalol may also cause sensitivity to cold weather, so be careful to wear warm clothes Avoid exposure to cold for long periods.?

Category

Chemical class: Benzamine derivative
Therapeutic class: Antihypertensive

Pregnancy category: C

Indications

To manage hypertension
Adults. Initial: 100 mg b.i.d., increased by 100 mg b.i.d. as needed and tolerated every 2 to 3 days. Maintenance: 200 to 400 mg b.i.d. For severe hypertension, 1.2 to 2.4 g daily in divided doses b.i.d. or t.i.d. To manage severe hypertension and treat hypertensive emergencies
IV:
Adults. 200 mg diluted in 160 ml of D5W and infused at 2 mg/min until desired response occurs.
I.V.INJECTION
Adults.20 mg given over 2 min; additional doses given in increments of 40 to 80 mg every 10 min as indicated until desired response occurs. Maximum: 300 mg. Route Onset Peak Duration P.O. 20 min– 1–4 hr 8–24 hr 2 hr I.V. 2–5 min 5–15 min 2–4 hr

Mechanism of Action

Selectively blocks alpha1and beta2receptors in vascular smooth muscle and beta1 receptors in heart to reduce peripheral vascular resistance and blood pressure. Potent beta blockade prevents reflex tachycardia, which commonly occurs when alpha blockers reduce resting heart rate, cardiac output, or stroke volume.

Incompatibilities

Don’t dilute labetalol in sodium bicarbonate solution or give through same I.V. line as alkaline , such as furosemide; doing so may cause white precipitate to form.

Contraindications

Asthma, cardiogenic shock, heart failure, hypersensitivity to labetalol or its components, secondor third-degree heart block, severe bradycardia

Interactions

allergen immunotherapy, allergenic extracts for skin testing: Increased risk of serious systemic reaction or anaphylaxis beta blockers, digoxin: Increased risk of bradycardia calcium channel blockers, clonidine, diazoxide, guanabenz, reserpine: Possibly hypotension
cimetidine: Possibly increased labetalol effects estrogens,
NSAIDs: Possibly reduced antihypertensive effect of labetalol general anesthetics: Increased risk of hypotension and myocardial depression insulin, oral antidiabetic : Increased risk of hyperglycemia nitroglycerin: Possibly hypertension phenoxybenzamine, phentolamine: Possibly additive alpha1-blocking effects sympathomimetics with alphaand betaadrenergic effects (such as pseudoephedrine): Possibly hypertension, excessive bradycardia, or heart block xanthines (aminophylline and theophylline): Possibly decreased therapeutic effects of both all food: Increased blood labetalol level
alcohol use: Increased labetalol effects

Side Efect

CNS: Anxiety, confusion, depression, dizziness, drowsiness, fatigue, paresthesia, syncope, vertigo, weakness, yawning
CV: Bradycardia, chest pain, edema, heart block, heart failure, hypotension, orthostatic hypotension, ventricular arrhythmias
EENT: Nasal congestion, taste perversion
GI: Elevated liver function test results, hepatic necrosis, hepatitis, indigestion, nausea, vomiting
GU: Ejaculation failure, impotence
RESP: Dyspnea, wheezing
SKIN: Jaundice, pruritus, rash, scalp tingling

Cautions

During I.V. labetalol use, monitor blood pressure according to facility policy, usually every 5 minutes for 30 minutes, then every 30 minutes for 2 hours, and then every hour for 6 hours.

Keep patient in supine position for 3 hours after I.V. administration.
WARNING Be aware that labetalol masks common signs of shock.

Monitor blood glucose level in diabetic patient because labetalol may conceal symptoms of hypoglycemia.

Be aware that stopping labetalol tablets abruptly after long-term therapy could result in angina, MI, or ventricular arrhythmias. Expect to taper dosage over 2 weeks while monitoring response.

PATIENT SAFTY

Advise patient to report confusion, difficulty breathing, rash, slow pulse, and swelling in arms or legs.

Caution patient not to stop drug abruptly because doing so could cause angina and rebound hypertension.

Suggest that patient minimize effects of orthostatic hypotension by rising slowly, avoiding sudden position changes, and taking labetalol at bedtime, if approved by prescriber.

Instruct diabetic patient to check blood glucose level often and to be alert for signs and symptoms of hypoglycemia.

Inform patient that scalp tingling may occur early in treatment but is transient.

Urge patient to avoid alcohol during labetalol therapy.

Trade Name & Company Name

Trade name	Company name
TRANDATE INJ.?100 MG.-AMP.20ML	GLAXO
TRANDATE TAB 200 MG.	GLAXO
TRANDATE TAB 100 MG.	GLAXO
TRANDATE 100MG TABLET	GLAXOWELLCOME

effect of Labetalol in Pregnancy, Fetal Health and Breast feeding

Pregnancy

. Hypertensive disorders complicate 5-10% of pregnancies and are a leading cause of maternal and perinatal morbidity and death. Severe hypertension (systolic BP >170mmHg and/or diastolic BP >110mmHg) should be treated rapidly to reduce the risk of stroke, death, and possibly eclampsia in preeclamptic women. There is no consensus whether mild to moderate hypertension should be treated during pregnancy. The risks of transient severe hypertension, the likelihood of antenatal hospitalization, proteinuria at delivery, and neonatal RDS may be decreased by therapy. Labetalol reduces BP more slowly than nifedipine, and it does not increase the maternal cardiac index as nifedipine does. Thus, labetalol is the drug of choice for hypertensive women with tachycardia. Labetalol has a lower risk of hypotension than parenteral hydralazine. Labetalol is better tolerated than methyldopa and provides more efficient BP control. It reduces cerebral pressure without altering cerebral perfusion. IV labetalol is equally effective as IV hydralazine for the treatment of postpartum hypertension. Labetalol may also be useful for the treatment of maternal thyrotoxicosis during labor.

Fetal Health

Labetalol crosses the human placenta, yielding an F:M ratio of 0.5 and an AF:M ratio <0.20. Neither labetalol nor hydralazine vasodilates the perfused human cotyledon. Doppler flow studies reveal no change in umbilical, uterine, and middle cerebral resistances after treatment. IV labetalol can cause fetal bradycardia. The available data are inadequate to determine whether labetalol adversely affects fetal or neonatal HR and pattern. Until such data are available, FHR changes should not be attributed to a drug effect, but rather to progression of the underlying maternal or placental disease. Hypoglycemia, bradycardia, hypotension, pericardial effusion, and myocardial 559 hypertrophy are reported after long-term oral labetalol. Fetal death may also occur after a sudden drop in the maternal BP, the risk of which can be minimized by adequate hydration. Overall, neonatal outcome is similar to that achieved with hydralazine. Labetalol may be useful for the treatment of fetal thyrotoxicosis. Rodent studies are reassuring, revealing no evidence of teratogenicity or IUGR despite the use of doses higher than those used clinically. Labetalol reduces uteroplacental blood flow selectively in guinea pigs, perhaps explaining the increased frequency of IUGR in this model.

Breastfeeding

There is no consistent relation between maternal plasma and milk concentrations either within or between individuals. The risk of hypoglycemia in breastfed neonates is increased by labetalol but may be blunted with glucose-fortified formula.

the follwing drugs will increse Labetalol by inhepiting cyp450

armodafinil ; chloramphenicol ; cimetidine ; citalopram ; esomeprazole ; felbamate ; fluconazole ; fluoxetine ; fluvoxamine ; isoniazid ; ketoconazole ; luliconazole ; modafinil ; omeprazole ; oral contraceptives ; oritavancin ; pantoprazole ; quercetin ; ticlopidine ; topiramate ; voriconazole ;

the follwing drugs will decrease Labetalol by inhancing cyp450

carbamazepine ; efavirenz ; enzalutamide ; letermovir ; norethindrone ; prednisone ; rifampicin ; ritonavir ;

Non-cardioselective beta blockers

...

Gen name	Trade name	Catagory name
labetalol	Trandate	Non-cardioselective beta blockers
labetalol 1 review	Normodyne	Non-cardioselective beta blockers
Labetalol	TRANDATE 100MG TABLET
Labetalol	TRANDATE INJ.?100 MG.-AMP.20ML
Labetalol	TRANDATE TAB 100 MG.
Labetalol	TRANDATE TAB 200 MG.

Gen name	trade name	catogry
propranolol	Inderal	Non-cardioselective beta blockers
carvedilol	Coreg	Non-cardioselective beta blockers
propranolol	Inderal LA	Non-cardioselective beta blockers
nadolol	Corgard	Non-cardioselective beta blockers
carvedilol	Coreg CR	Non-cardioselective beta blockers
propranolol	InnoPran XL	Non-cardioselective beta blockers
sotalol	Betapace AF	Non-cardioselective beta blockers
sotalol	Betapace	Non-cardioselective beta blockers
pindolol	Visken	Non-cardioselective beta blockers
labetalol	Trandate	Non-cardioselective beta blockers
labetalol 1 review	Normodyne	Non-cardioselective beta blockers
sotalol	Sotylize	Non-cardioselective beta blockers
sotalol	Sorine	Non-cardioselective beta blockers
penbutolol	Levatol	Non-cardioselective beta blockers
propranolol	Hemangeol	Non-cardioselective beta blockers
timolol	Blocadren	Non-cardioselective beta blockers