The drug is commercially available as a racemic mixture of its 4 stereoisomers. Request pdf labetalol for hypertension in pregnancy labetalol is one of the most commonly used antihypertensive medications for the treatment of hypertension during pregnancy, an increasingly. It has two asymmetric centers and therefore exists as a molecular complex of two diastereoisomeric pairs. Mar 28, 2020 exposure to labetalol during pregnancy may increase the risk for adverse events in the neonate. The objective of this evidence summary is to inform and advise a discussion on the inclusion of labetalol in the essential medicines list as an additional option for hypertension in pregnancy, and determine if atenolol is a suitable replacement for labetalol. Labetalol is one of the most commonly used antihypertensive medications for the treatment of hypertension during pregnancy, an increasingly common and leading cause of maternal mortality and. Im 22 weeks pregnant and have been having some issues, ive asked this same question in many of the other boards but have yet to have any responses on it. Iv labetalol practice guideline for care of patients with acute hypertension page 3 of 4 this is a controlled document for internal use only.
The recommended initial dose is 200 mg orally, followed in 6 to 12 hours by an additional dose of 200 or 400 mg orally, depending on the blood pressure response. This is the time when you need to stay healthy and keep at bay complications. Labetalol hydrochloride is an alpha and betaadrenergic blocking agent. My obgyn and cardiologist prescribed me labetalol to decrease my heart rate and bp. Labetalol for hypertension in pregnancy request pdf. If maternal use of a betablocker is needed, fetal growth should be monitored during pregnancy and the newborn should be monitored for 48 hours after delivery for bradycardia, hypoglycemia, and respiratory depression esc regitzzagrosek 2018. Commonly prescribed drugs in pregnancy for further information including full details of contraindications, cautions, drug interactions and adverse effects always check with bnf uk or spc uk. Because labetalol is a combined alpha and beta blocker, most of the crappy beta blocker side effects are gone with it. May 03, 2020 while experience with labetalol in the acute treatment of severe hypertension in pregnancy is less well documented, comparative studies suggest that parenteral use of labetalol is at least. Labetalol is a prescription medication used to treat high blood pressure. I have done much research about this medication and the potential risks for my unborn daughter, malia. Nda 18716s026 page 3 single oral doses of labetalol hcl administered to patients with coronary artery disease had no significant effect on sinus rate, intraventricular conduction, or qrs duration.
The pulmonary circulation during exercise was not affected by labetalol hcl dosing. Labetalol possesses intrinsic sympathomimetic activity. Neonatal side effects of maternal labetalol treatment in. Labetalol is a medication used to treat high blood pressure and in long term management of angina. Labour and childbirth the first weeks with your new baby. However, i too have a serious case of white coat syndrome. I was prescribed it by my consultant as my bp had gone from 12070 at start of pregnancy to 160100 that day. Labetalol is an adrenoceptor blocking drug with combined. So its important to get uptodate, trusted advice so that you can make the right decisions and choices. Labetalol disposition and concentrationeffect relationships. Thereafter, inpatient titration with labetalol hydrochloride tablets may proceed as follows. Labetalol while pregnant welcome to the preeclampsia foundation. Which drugs or supplements interact with labetalol.
I had weekly monitoring at the assessment unit and remained on labetalol for around a year after having my son. This can put the mother and her baby at risk for problems during the pregnancy. There has been little research done concerning the effects of labetalol on human fetuses. Breastfeeding despite low excretion into breast milk approximately 0. High blood pressure can also cause problems during and after delivery. In the united states, high blood pressure happens in 1.
Iv labetalol and oral nifedipine in acute control of severe hypertension in pregnancy a randomized controlled trial source. I had high blood pressure form the start of my first pregnancy around 14090 and was put on labetalol from around 30 weeks i think. Labetalol hcl has the molecular formula c 19 h 24 n 2 o 3 hcl and a molecular weight of 364. Final thoughts the fda classifies labetalol as a pregnancy category c medicine based on the animal research, along with sporadic cases of problems with labetalol in humans. It is important to control high blood pressure for the health of the mother and unborn baby. It works by relaxing blood vessels and slowing heart rate to improve blood flow and decrease blood pressure. Most adverse effects are mild and transient and occur early in the course of treatment. High blood pressure, also called hypertension, is very common. The only side effect i had was some mild dizziness when the labetalol dose was increased but it only lasted one day. In particular, it is a partial agonist at beta2 receptors located in the vascular smooth muscle. Beta 50 mg is not available in the market,so the chemist has given lobet 100 mg to be taken half in the morning and half in the evening.
Its common to develop hypertension, or high blood pressure, during pregnancy. Labetalol has been around for a long time and studies have been done in conjunction with pregnancy. These work by relaxing blood vessels and slowing the heart rate to improve blood flow and decrease blood pressure. Results for labetalol in pregnancy 1 10 of 78 sorted by relevance date. Theres also aldometmethyldopa and nifedipineprocardia that can be prescribed. Hypertensive disorders during pregnancy affect about 10% of pregnant women worldwide,, while the antihypertensive treatment seems to be crucial reducing the risk of severe hypertension in pregnant women. A retrospective study in hypertensive patients treated during pregnancy with nifedipine or labetalol was conducted. While experience with labetalol in the acute treatment of severe hypertension in pregnancy is less well documented, comparative studies suggest that parenteral use of labetalol is at least.
We analyzed the possible association between intrauterine labetalol exposure and such side effects. Trandate labetalol is a betablocker used to treat hypertension high blood pressure. Some doctors also prescribe labetalol by mouth for daily outpatient treatment of high blood pressure. Overall, this vasodilatory effect can decrease blood pressure.
Labetalol is a combined alpha1 and beta blocker with a rapid onset of action and duration of two to three overview of acute aortic dissection and other acute aortic syndromes view in chinese patients who might be intolerant of beta blockers due to asthma or heart failure, for example. Labetalol has been used to treat high blood pressure in pregnant women. Dailymed labetalol hcl labetalol hydrochloride tablet. It is indicated for the treatment of mild, moderate or severe hypertension, patients with angina pectoris in. The maximum dose of labetalol prescribed was 1200 mg daily. I was diagnosed with pp pree after daughter was born. Any documents appearing in paper form are not controlled and should be checked against the electronic file version prior to use.
Cochrane central register of controlled trials 01 may 2019 publisher. Six of these had a twin pregnancy and 54 had proteinuria. With other beta blockers, there have been individual reports of slowed growth before birth, small placentas, and birth defects in women who took these drugs during pregnancy. They put me on procardia before the labetalol and i had the worst headaches. I had preeclampsia in my last pregnancy, picked up at 38 weeks. May 12, 2012 to assess the maternal and fetal outcomes of pregnancies affected by hypertensive disorders treated with nifedipine versus labetalol. Labetalol while pregnant welcome to the preeclampsia.
Labetalol during pregnancy and nipple pain introduction labetalol is a selective. There were no significant maternal or foetal sideeffects. Pregnancy category c is given to medicines that have not been studied in pregnant humans. Labetalol is in a class of medications called beta blockers.
Report any rhythm disturbances or symptoms of increased arrhythmias, including palpitations, chest discomfort, shortness of breath, fainting, and fatigueweakness. Im not a doctor, but maybe you need a larger dose of labetalol or something else. Labetalol for prophylactic treatment of intractable. Im 22 weeks pregnant and have been having some issues, ive asked this same question in many of the other. Labetalol for prophylactic treatment of intractable migraine. Request pdf labetalol for prophylactic treatment of intractable migraine during pregnancy headaches tend to improve in the majority of migraineurs during pregnancy, but some patients report a. By continuing to browse this site you are agreeing to our use of cookies. Is labetalol safe to take if im pregnant or breastfeeding. High blood pressure is a common condition and when not treated, can cause damage to the brain, heart, blood vessels, kidneys and. Hypertension ht in pregnancy is a risk factor for maternal and perinatal morbidity and mortality. European journal of obstetrics, gynecology, and reproductive biology. My doc put me on 30 mg of procardia xl well, the generic version and that worked like a charm. Labetalol comes in tablet form to be taken by mouth.
Is it the same medicine which the doctor has prescribed. It is safe to take during pregnancy labetalol pregnancy. I think it is a good choice and if it doesnt work for you there are other choices you can explore with your provider. Dec 04, 2019 labetalol pregnancy warnings animal studies have failed to reveal evidence of teratogenicity, although an increased incidence of fetal resorption was demonstrated in some studies at doses approximating the maximum recommended human dose. Hypotension, bradycardia and hypoglycemia are feared neonatal side effects, but may also occur in preterm infants regardless of labetalol exposure.
In the other two groups labetalol did not lower pressure sufficiently to allow modelling to be performed. Labetalol relaxes vascular smooth muscle by a combination of this partial beta2 agonism and through alpha1 blockade. Assess heart rate, ecg, and heart sounds, especially during exercise see appendices g, h. Click export csv or ris to download the entire page or use the checkboxes to select a subset of records to download. In my practice, we almost exclusively use labetalol for htn in pregnancy. It can be given by mouth or by injection into a vein. The rr isomer has about 24 times the betaadrenergic blocking activity of the racemic mixture but has only minimal alpha1adrenergic blocking activity. Nifedipine versus labetalol in the treatment of hypertensive. This includes essential hypertension, hypertensive emergencies, and hypertension of pregnancy. I have been on labetalol for chronic hypertension for 5 years 300 mg twice a day and procardia xl 30 mg at night for 2 years. To assess the maternal and fetal outcomes of pregnancies affected by hypertensive disorders treated with nifedipine versus labetalol. I was taking procardia 60 mg once a day before i got pregnant and for about 5 wks of pregnancy but my ob changed to labetalol. What is labetalol, and how does it work mechanism of action.
Labetalol pregnancy warningsanimal studies have failed to reveal evidence of teratogenicity, although an increased incidence of fetal resorption was demonstrated in some studies at doses approximating the maximum recommended human dose. In controlled clinical trials of 3 to 4 months duration, discontinuation of trandate labetalol tablets due to one or more adverse effects was required in 7% of all patients. Hypertensive disorders of pregnancy refer to online version, destroy printed copies after use page 2 of 32. Hi dr xxxxxxx i am 35 weeks pregnant and my bp is 694 and doctor has prescribed lobet 50 mg or l beta 50 mg to control bp. Hypertensive disorders of pregnancy refer to online version, destroy printed copies after use page 4 of 32 flowchart. Pregnancy category c is given to medicines that have not been studied in pregnant humans but show side effects to the fetus during animal studies. Labetalol hcl is a white or offwhite crystalline powder, soluble in water. These result in a more favourable haemodynamic profile for labetalol compared with pure. I was on 1200 mg labetalol and that still wasnt enough to control my bp it was really high 190100.
The labetalol dose got increased during my 3rd trimester. Reports of use of labetalol in pregnancy were published in the late 1970s, stimulated by the hope that parenteral labetalol would offer an advantage to parenteral diazoxide or hydralazine for treatment of severe hypertension, or oral methyldopa or propranolol for nonsevere hypertension 3. Labetalol for high bp anyone refused to take it or wish. Hydralazine is an orally or intravenously administered direct. This medication belongs to a group of drugs called beta blockers.
Labetalol side effects, uses, dosage, overdose, pregnancy. Usually it starts after youve been pregnant for about 20 weeks. Labetalol is an alpha and betablocker drug used to lower high blood pressure during pregnancy. Labetalol hydrochloride tablets labetalol hydrochloride. The medicine is available in the name of labetalol tablets. Sep 28, 20 labetalol is a prescription medication used to treat high blood pressure. If you have any questions or concerns no matter how trivial. In the case where you have a high blood pressure during pregnancy, you may be prescribed labetalol to decrease the heart rate and improve blood flow to keep down the blood pressure.
803 210 484 573 1107 444 842 224 1319 306 337 1475 1480 867 1080 650 1288 554 1080 516 1418 1269 428 482 497 504 1418 1480 289 575 733 204 739