Combined α/β-blocker
Labetalol hydrochloride
Brand names: Trandate
Adult dose
Dose: PO: initial 100mg BD, increase to usual 200–400mg BD (max 2.4g/day in divided doses). IV (hypertensive emergency / pregnancy): 50mg slow IV over 1 min, repeat every 5 min up to 200mg; or 20mg/h infusion increasing every 30 min to max 160mg/h
Route: PO/IV
Frequency: BD-QDS
Clinical pearls
- First-line for hypertension in pregnancy/pre-eclampsia (alongside hydralazine, methyldopa, nifedipine)
- Hypertensive urgency/emergency
Contraindications
- Asthma
- Severe bradycardia
- 2nd/3rd degree AV block (without pacemaker)
- Cardiogenic shock
- Phaeochromocytoma without α-blockade established
Side effects
- Postural hypotension
- Bradycardia
- Bronchospasm
- Hepatotoxicity (rare but serious)
- Tingling of scalp
Interactions
- Calcium-channel blockers (bradycardia)
- Other antihypertensives
Monitoring
- BP
- HR
- LFTs
Reference: BNF; NICE NG133; ESC; https://bnf.nice.org.uk/drugs/labetalol-hydrochloride/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
Pathways
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines