Active Ingredient: Labetalol
Severe hypertension of pregnancy, when rapid control of blood pressure is essential.
For this indication, competent medicine agencies globally authorize below treatments:
For:
Regimen A :
Intravenous bolus, 50 milligrams labetalol, once every 5 minutes, 1 to 4 doses in total.
Regimen B :
Intravenous, 20 milligrams labetalol, once hourly. The maximum allowed total dose is 160 milligrams labetalol hourly.
Labetalol injection is intended for intravenous use in hospitalised patients. The plasma concentrations achieved after intravenous dose of labetalol in severe hypertension are substantially greater than those following oral administration of the drug and provide a greater degree of blockade of alpha-adrenoceptors necessary to control the more severe disease. Patients should, therefore, always receive the drug whilst in the supine or left lateral position. Raising the patient into the upright position, within three hours of intravenous labetalol administration, should be avoided since excessive postural hypotension may occur.
| Indication | Dosage |
| Severe hypertension | Bolus injection: If it is essential to reduce blood pressure quickly, as for example in hypertensive encephalopathy, a dose of 50 mg of labetalol hydrochloride should be given by intravenous injection (over a period of at least one minute). If necessary, doses of 50 mg may be repeated at five minute intervals until a satisfactory response occurs. The total dosage should not exceed 200 mg. After bolus injection, the maximum effect usually occurs within five minutes and the effective duration of action is usually about 6 hours but may be as long as 18 hours. |
| em>Intravenous infusion An alternative method of administering labetalol is intravenous infusion of a solution made by diluting the contents of four 10 ml ampoules (200 mg) to 200 ml with Sodium Chloride and Dextrose Injection, 5% dextrose Intravenous Infusion, Potassium Chloride and Glucose solution or Ringer Lactate. The resultant infusion solution contains 1 mg/ml of labetalol hydrochloride. It should be administered using a paediatric giving set fitted with a 50 ml graduated burette to facilitate dosage. In the hypertension of pregnancy: In severe cases of hypertension of pregnancy a lower, increasing infusion rate needs to be administered. The infusion needs to be started at the rate of 20 mg/hour, and this dose may be doubled every 30 minutes until a satisfactory result has been obtained, or a dosage of 160 mg/hour is reached. Occasionally, higher doses may be necessary. In hypertensive episodes following acute myocardial infarction: The infusion should be commenced at 15 mg per hour and gradually increased to a maximum of 120 mg per hour depending on the control of blood pressure. |
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