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Labetalol

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Dec 15, 2021

Labetalol is a medication used to treat high blood pressure and in long term management of angina.[1][2] This includes essential hypertension, hypertensive emergencies, and hypertension of pregnancy.[2] In essential hypertension it is generally less preferred than a number of other blood pressure medications.[1] It can be given by mouth or by injection into a vein.[1]

Medication used to treat high blood pressure
Labetalol
Clinical data
Pronunciation /ləˈbɛtəlɔːl/
Trade names Normodyne, Trandate, others
AHFS/Drugs.com Monograph
MedlinePlus a685034
License data
Pregnancy
category
  • AU: C
Routes of
administration
By mouth, intravenous
ATC code
Legal status
Legal status
  • AU: S4 (Prescription only)
  • In general: ℞ (Prescription only)
Pharmacokinetic data
Bioavailability 25%
Protein binding 50%
Metabolism Liver pass metabolism,
Elimination half-life Tablet: 6-8 hours; IV: 5.5 hours
Excretion Excreted in urine, not removed by hemodialysis
Identifiers
  • (RS)-2-Hydroxy-5-[1-hydroxy-2-[(4-phenylbutan-2-yl)amino]ethyl]benzamide
CAS Number
PubChemCID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard(EPA)
ECHA InfoCard 100.048.401
Chemical and physical data
Formula C19H24N2O3
Molar mass 328.412 g·mol−1
3D model (JSmol)
Chirality Racemic mixture
  • O=C(c1cc(ccc1O)C(O)CNC(C)CCc2ccccc2)N
  • InChI=1S/C19H24N2O3/c1-13(7-8-14-5-3-2-4-6-14)21-12-18(23)15-9-10-17(22)16(11-15)19(20)24/h2-6,9-11,13,18,21-23H,7-8,12H2,1H3,(H2,20,24) Y
  • Key:SGUAFYQXFOLMHL-UHFFFAOYSA-N Y

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Common side effects include low blood pressure with standing, dizziness, feeling tired, and nausea.[1] Serious side effects may include low blood pressure, liver problems, heart failure, and bronchospasm.[1] Use appears safe in the latter part of pregnancy and it is not expected to cause problems during breastfeeding.[2][3] It works by blocking the activation of β-receptors and α-receptors.[1]

Labetalol was patented in 1966 and came into medical use in 1977.[4] It is available as a generic medication.[2] In 2017, it was the 211th most commonly prescribed medication in the United States, with more than two million prescriptions.[5][6]

. . . Labetalol . . .

Labetalol is effective in the management of hypertensive emergencies, postoperative hypertension, pheochromocytoma-associated hypertension, and rebound hypertension from beta blocker withdrawal.[7]

It has a particular indication in the treatment of pregnancy-induced hypertension which is commonly associated with pre-eclampsia.[8]

It is also used as an alternative in the treatment of severe hypertension.[7]

Pregnancy: studies in lab animals showed no harm to the baby. However, a comparable well-controlled study has not been performed in pregnant women.[9]

Nursing: breast milk has been shown to contain small amounts of labetalol (0.004% original dose). Prescribers should be cautious in the use of labetalol for nursing mothers.[9]

Pediatric: no studies have established safety or usefulness in this population.[9]

Geriatric: the elderly are more likely to experience dizziness when taking labetalol. Labetalol should be dosed with caution in the elderly and counseled on this side effect.[9]

. . . Labetalol . . .

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. . . Labetalol . . .