Name: LABETALOL (TrandateR)
Classification: combined alpha and  beta receptor blocker; antihypertensive
  • decreases blood pressure (alpha blockade)
  • decreases HR, contractility, myocardial oxygen requirements (beta blockade)
Dose:
  • Bolus:
    • 5-20 mg IV direct initially; additional doses of 40-80 mg may be given at 10 minute intervals
  • Infusion:
    • 2 mg/min with the rate of infusion adjusted to supine BP
    OR
    • infusion of 0.5 - 1.0 mg/kg/hr titrated to effect
Administration:
  • Bolus dose:
    • 5-20 mg IV direct over a 2 minute period
    • bolus should be diluted to a concentration of 1 mg/mL
  • IV Infusion:
    • 500 mg/100 mL in D5W, NS, RL
Adverse Effects:
  • bradycardia
  • decreased contractility, cardiac output
  • ventricular arrhythmias (including PVCs)
  • excessive drops in BP - especially orthostatic hypotension (patients should be kept supine for 3 hours after administration)
  • parasthesia (mild, transient tingling of scalp or skin)
  • dyspnea, bronchospasm
  • pain at injection site
Caution:
  • caution in left ventricular dysfunction, bronchospastic disease, pheochromocytoma (additional alpha blockade required), hepatic dysfunction
Drug Interactions:
  • labetalol + nitroglycerin = additive hypotensive effect
  • labetalol + beta2 agonists = decreased bronchodilation
Monitoring Therapy:
  • HR and rhthym
  • BP
  • breath sounds (presence of bronchospasm or wheezing) 
  • cardiac index
CCTC Protocol:
  • May be administered IV direct by an approved nurse in the CCTC.
  • May be titrated by an approved nurse in CCTC.
  • Should be infused via a central line.
  • Continuous infusion must be administerd via an infusion pump.
  • Should not be infused via the proximal injectate port (blue) of the Swan Ganz catheter.
  • Patient requires placement of an arterial line to monitor BP.


Lynne Kelly, Pharmacist, CCTC
Brenda Morgan, Clinical Nurse Specialist, CCTC
Last Update: January 12, 2017

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Last Updated January 12, 2017 | © 2007, LHSC, London Ontario Canada