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Labetalol

Hypertensive emergency, Aortic dissection, Preeclampsia/eclampsia

Indications

  • Hypertensive emergency
  • Aortic dissection
  • Preeclampsia/eclampsia

Adult dosing

  • push: dose: 20; unit: mg IV; route: IV; interval: then 40-80mg q10min, max 300mg; fixed: true; infusion: dose: 0.5; maxDose: 2; unit: mg/min; route: IV; fixed: true

Pediatric dosing

  • push: dose: 0.2; maxDose: 1; unit: mg/kg; route: IV; weightBased: true

Contraindications

  • Severe bradycardia
  • Heart block (2nd/3rd degree)
  • Cardiogenic shock
  • Decompensated HF
  • Severe reactive airway disease

Clinical pearls

  • Escalating dose protocol: 20mg, then 40mg, then 80mg IV q10min
  • First-line for aortic dissection with esmolol or clevidipine
  • Safe in pregnancy — preferred for preeclampsia
  • Combined alpha + beta blocker — HR and BP reduction

Source and review

  • ACOG Practice Bulletin; AHA/ACC Aortic Disease Guidelines. Last reviewed: 2024-11-01