Parenteral Manual

Labetalol

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
TRANDATE®
Classification: 
Antihypertensive agent
Original Date: 
August 2005
Revised Date: 
July 2026
Indications: 
  • Treatment of severe hypertension and hypertensive emergencies
  • Blood pressure management with reperfusion therapy 
Reconstitution and Stability: 
  • Available as a 5 mg/mL solution
  • Store at room temperature
  • Protect from light
  • Stable for 72 hours in compatible IV solutions at room temperature or refrigerated
Compatibility: 
  • Solutions Compatible: D5W, NS, dextrose-saline combinations, ringer's solution, ringer's lactate
  • Additives/Above Cassette Compatible: no information
  • Y-site Compatible: amiodarone, dobutamine, esmolol, KCl, meperidine, morphine, norepinephrine, propofol
  • Incompatible: amphotericin, ceftriaxone, furosemide, sodium bicarbonate
Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM NO
IV Direct

YES; cardiac monitoring and continuous BP monitoring  Critical care areas only
Usual dilution: 5 mg/mL
Infusion time: 2-3 minutes
Infusion rate: Maximum: 2 mg/minute

IV Intermittent Infusion

NO

IV Continuous Infusion

YES cardiac monitoring, BP monitoring
Usual dilution:  5 mg/mL

Click here to access SDC Drug Infusion Sheet
 

Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Pediatric:

Hypertensive Emergency

IV Direct:    

  • 0.2-1 mg/kg/dose IV every 10 minutes as needed 
  • Maximum: 40 mg/dose

Continuous IV infusion:

  • Initial: 0.25 - 1 mg/kg/hour
  • Titrate by increments of 0.25 to 0.5 mg/kg/hour as needed to control BP
  • Maximum: 3 mg/kg/hour (rates up to 8 mg/hour have been used)

Acute Ischemic Stroke (BP management with reperfusion therapy)

IV Direct:

  • 0.5 mg/kg/dose IV every 10 minutes as needed to maintain systolic blood pressure within target
  • Maximum: 40 mg/dose
  • After 3 doses have been given and desired BP is not achieved, switch to continuous infusion

Continuous Infusion: 

  • Initial: 0.5-1 mg/kg/hour
  • Titrate by increments of 0.5 mg/kg/hour every 10 minutes to maintain systolic blood pressure within target
  • Maximum: 3 mg/kg/hour (rates up to 8 mg/hour have been used)
Potential hazards of parenteral administration: 
  • Postural hypotension, dizziness
  • Nausea/vomiting, drowsiness, fatigue, paresthesias (especially scalp tingling)
  • Bronchospasm
  • Bradycardia
  • Somnolence, vertigo
Notes: 
  • Contraindicated in asthma, obstructive airway disease, greater than first degree heart block, cardiogenic shock, severe bradycardia, uncontrolled CHF, pulmonary edema
  • Caution in patients with diabetes mellitus (masks signs of hypoglycemia), impaired hepatic function (metabolized in liver) and pheochromocytoma (paradoxical hypertensive responses)
  • Additive hypotensive response may occur with halothane or isoflurane anesthesia
  • Patients should remain supine during and for up to three hours after IV administration
  • Monitor blood pressure, heart rate, pulse, EKG
  • Onset: 2-5 minutes; duration: 2-4 hours

 

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