labetalol
Labetalol is a medication that works as both an alpha blocker and beta blocker. It's used to treat high blood pressure in adults. But it's not a first-choice medication for blood pressure, except during pregnancy. Labetalol is typically taken by mouth twice a day. It can also be given through the veins by a healthcare professional, usually in a hospital setting, to treat dangerously high blood pressure. Common side effects of oral labetalol include dizziness and feeling tired. This medication is only available as a generic; brand name Trandate has been discontinued.
What is Labetalol?
What is Labetalol used for?
How Labetalol works
Labetalol is both an alpha blocker and a non-selective beta blocker. It blocks alpha-1 receptors, which widens blood vessels and lowers blood pressure. Labetalol also blocks beta receptors, which slows down heart rate so your heart doesn't have to work as hard to pump blood through the body.
Drug facts
Side effects of Labetalol
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Dizziness (11%)
- Nausea (6%)
- Feeling tired (5%)
- Indigestion (3%)
- Stuffy nose (3%)
- Headache (2%)
Less Common Side Effects
- General weakness
- Vomiting
- Diarrhea
- Changes in taste
- Tingling sensation
- Drowsiness
- Sexual dysfunction
- Increased sweating
- Swelling
- Changes in vision
Labetalol serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Worsening heart failure: shortness of breath, unusual swelling, tiredness, and sudden weight gain
- Bronchospasm: tightness in the chest, trouble catching your breath, difficulty breathing, wheezing, cough, dizziness, extreme tiredness
More on Labetalol side effects
The following Labetalol side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Chest pain or discomfort
lightheadedness, dizziness, or fainting
slow or irregular heartbeat
sweating
unusual tiredness or weakness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Less common
Acid or sour stomach
belching
change in taste or bad, unusual, or unpleasant (after) taste
decreased interest in sexual intercourse
feeling of constant movement of self or surroundings
headache
inability to have or keep an erection
indigestion
lack or loss of strength
loss in sexual ability, desire, drive, or performance
not able to ejaculate semen
rash
sensation of spinning
stomach discomfort, upset, or pain
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Labetalol
Pros
- Less likely to affect heart rate than other beta blockers
- Less likely to cause weight gain than other beta blockers
- Safe to take during pregnancy
Cons
- Causes higher risk of wheezing and breathing problems compared to selective beta-blockers
- Need to take twice a day (and three times a day for some people)
- Stopping the medication suddenly can worsen chest pain
Pharmacist tips for Labetalol
- You can track how well labetalol is working by checking your blood pressure regularly at home. Write down your blood pressure readings, and bring them to your appointments with your primary care provider so you can discuss how well labetalol is working for you.
- Consider avoiding alcohol while taking labetalol) because taking the two together can make you more drowsy and dizzy. If you drink alcohol regularly and it's difficult to stop completely, talk with your primary care provider about what's a safe amount to drink.
- Taking labetalol can hide certain symptoms of low blood sugar, such as tremors and irritability. If you have diabetes, you might not be able to rely on all the typical symptoms of low blood sugar to warn you of a dangerous drop in your sugar levels. Sweating might be the only symptom not affected by taking labetalol.
- Don't stop taking labetalol suddenly. Doing so can cause your blood pressure to go up, which can raise the risk of heart attack, chest pain, and stroke. If you want to stop this medication, your primary care provider can lower your dose slowly over time.
Common questions about Labetalol
Yes, labetalol can lower your heart rate. It treats high blood pressure by blocking beta receptors in the heart, which slows down heart rate. At the same time, it also blocks alpha receptors, which relaxes and widens blood vessels, making it easier for blood to flow. Research suggests that labetalol has less of an effect on heart rate compared to other beta blockers that don't affect alpha receptors. Talk with your healthcare team if you have more questions about labetalol and heart rate.
It can take oral labetalol up to 2 hours to start working, and the effect can last at least 8 hours after each dose. Keep in mind that you have to take this medication as directed for 2 to 3 days in order for it to best lower your blood pressure. If you need to stop taking labetalol for any reason, let your healthcare team know. Don't suddenly stop labetalol because this not only raises your risk of high blood pressure and chest pain, but also your risk of having a heart attack.
Most side effects of labetalol, including dizziness, tiredness, and nausea, should go away as your body gets used to this medication. In the meantime, your healthcare team can find ways to help you manage these side effects. For example, they might suggest splitting your daily dose of labetalol into smaller doses to be taken three times a day instead of twice daily. They might also recommend that you stay hydrated and take a break from more intense physical activity if possible, until your body feels less tired. Talk with your healthcare team if you have more questions about any particular side effect.
People who took labetalol in clinical studies didn't report weight gain as a side effect. But in general, beta blockers can cause weight gain, usually during the first few months of starting treatment. This might happen because beta blockers can slow down metabolism, which can lead to weight gain. They might also cause you to be more tired, which can make it harder to stay active and exercise. To minimize weight gain, try to stick with an exercise routine that works for you. Talk with your healthcare team if you have more questions about labetalol and weight gain.
According to American College of Obstetricians and Gynecologists, labetalol is a first-choice medication for treating high blood pressure during pregnancy. If you're pregnant or thinking of becoming pregnant, talk with your healthcare team about options for managing your high blood pressure. If left untreated, high blood pressure can raise the risk of harm to you and your baby.
Labetalol and metoprolol tartrate (Lopressor) are both beta blockers that can help lower blood pressure. Metoprolol tartrate (Lopressor) is also prescribed to ease chest pain and lower the risk of death after a heart attack. Both medications are taken by mouth, typically twice daily. One difference is that labetalol is a non-selective beta blocker, which means it has a higher risk of causing trouble breathing than metoprolol tartrate (Lopressor). But labetalol is also an alpha blocker, which means it's less likely to cause slow heart rate. Talk with your healthcare team if you have more questions about the differences between labetalol and metoprolol.
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Risks and warnings for Labetalol
Labetalol can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Liver injury
- Risk factors: History of liver problems
In some rare cases, some people who take labetalol have reported severe liver injury, which can lead to liver failure and sometimes death. Keep in mind that this injury can occur whether you've taken this medication for a short or long period of time with very little symptoms. If you experience frequent itching, dark urine, weight loss, yellowing of the skin, stomach pain, or unexplained “flu-like” symptoms, let your healthcare team know right away. Your care team will ask you to do lab work to check your liver health. In some cases, you might be asked to stop taking labetalol.
Heart failure
- Risk factors: Heart failure | Sudden heart attack
Labetalol might lead to heart failure or worsen heart failure in people who already have it. This is because labetalol can slow down your heart, which leads to your heart muscle not pumping as often. In people with a history of heart problems, this can cause their heart to not work as well, leading to heart failure. People with heart failure shouldn't take labetalol if their heart failure symptoms aren’t well-managed. Discuss with your healthcare team before starting labetalol if you have a history of heart failure. Let your care team know right away if you experience symptoms such as trouble breathing, tiredness, swelling in your body, or sudden weight gain. Your healthcare team might ask you to stop this medication if you have symptoms of heart failure.
Worsening chest pain and heart attacks
- Risk factors: Stopping labetalol suddenly | History of coronary artery disease (CAD)
Don’t stop taking labetalol suddenly since it can worsen your chest pain or heart attack. If you need to stop taking this medication for any reason, let your healthcare team know. They can work with you to lower your dose safely over time. While your dose is being lowered, make sure to limit physical activity as much as possible to lower the stress on your heart. Watch out for symptoms of heart attack (e.g., chest pain and tightness, pain that spreads to arms and neck, trouble breathing, lightheadedness, fatigue). Get medical attention right away if you have any of these symptoms.
Risk of difficulty breathing
- Risk factors: Chronic obstructive pulmonary disease (COPD) | Asthma
Labetalol can cause the vessels in your lung to tighten. This can make breathing difficult, especially in people with breathing problems, like asthma. To be safe, make sure your healthcare team knows about your full medical history before starting this medication. Your care team will start you on the lowest dose possible that works well for you.
Hiding symptoms of low blood sugar
- Risk factors: Diabetes
Taking labetalol can make it difficult for you to identify some symptoms of low blood sugar, such as fast heart beat or tremors. If you’re taking blood sugar medications, you might not be able to rely on all the typical symptoms of low blood sugar to warn you of a dangerous drop in your sugar levels. Watch out for sweating, which isn't affected by labetalol, to identify low blood sugar episodes. If you have diabetes, speak with your healthcare team about how often to monitor your blood sugar once you start labetalol.
Greater risk during surgery
- Risk factors: Major surgery requiring anesthesia
If you're planning to undergo a major surgery requiring anesthesia, tell your surgeon that you are taking labetalol. Beta blockers, such as labetalol, might raise the risk of side effects from anesthesia. If you've been taking it for a while, your surgeon might not ask you to stop it, but they'll need to monitor your heart closely during your procedure.
Risk of heart block (medication interaction)
You should avoid taking labetalol with certain calcium channel blockers (CCBs), like diltiazem (Cardizem) or verapamil. Doing so can raise the risk of dangerously low heart rate and heart block.
Labetalol dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 100mg | 60 tablets | $13.75 | $0.23 |
| 200mg | 60 tablets | $18.31 | $0.31 |
| 300mg | 60 tablets | $21.78 | $0.36 |
| 400mg | 60 tablets | $38.40 | $0.64 |
Typical dosage for Labetalol
Adults: The typical starting dose is 100 mg by mouth twice daily. Your primary care provider will raise your dose every 2 to 3 days if you need to lower your blood pressure more. The usual maintenance dose ranges from 200-400 mg twice daily.
More on Labetalol dosage
Interactions between Labetalol and other drugs
More on Labetalol interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Albuterol
- Ceritinib
- Crizotinib
- Diltiazem
- Dronedarone
- Fenoldopam
- Fingolimod
- Formoterol
- Halothane
- Indacaterol
- Iobenguane I 123
- Iobenguane I 131
- Iohexol
- Lacosamide
- Levalbuterol
- Olodaterol
- Oxymetazoline
- Ponesimod
- Rivastigmine
- Salmeterol
- Siponimod
- Terbutaline
- Verapamil
- Vilanterol
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acarbose
- Aceclofenac
- Acemetacin
- Acetyldigoxin
- Albiglutide
- Alfuzosin
- Alogliptin
- Amtolmetin Guacil
- Arbutamine
- Aspirin
- Bromfenac
- Bufexamac
- Bunazosin
- Canagliflozin
- Celecoxib
- Chlorpropamide
- Choline Salicylate
- Cimetidine
- Clonixin
- Dapagliflozin
- Deslanoside
- Dexibuprofen
- Dexketoprofen
- Diclofenac
- Diflunisal
- Digitoxin
- Digoxin
- Dipyrone
- Doxazosin
- Droxicam
- Dulaglutide
- Empagliflozin
- Enflurane
- Epinephrine
- Ertugliflozin
- Etodolac
- Etofenamate
- Etoricoxib
- Exenatide
- Felbinac
- Fenoprofen
- Fepradinol
- Feprazone
- Floctafenine
- Flufenamic Acid
- Flurbiprofen
- Glimepiride
- Glipizide
- Glyburide
- Ibuprofen
- Indomethacin
- Insulin Aspart, Recombinant
- Insulin Degludec
- Insulin Detemir
- Insulin Glargine, Recombinant
- Insulin Glulisine
- Insulin Human Inhaled
- Insulin Human Isophane (NPH)
- Insulin Human Regular
- Insulin Lispro, Recombinant
- Isoflurane
- Ketoprofen
- Ketorolac
- Linagliptin
- Liraglutide
- Lixisenatide
- Lornoxicam
- Loxoprofen
- Lumiracoxib
- Magnesium Sulfate
- Meclofenamate
- Mefenamic Acid
- Meloxicam
- Metformin
- Metildigoxin
- Mibefradil
- Miglitol
- Morniflumate
- Moxisylyte
- Nabumetone
- Naproxen
- Nateglinide
- Nepafenac
- Niflumic Acid
- Nimesulide
- Nimesulide Beta Cyclodextrin
- Oxaprozin
- Oxyphenbutazone
- Parecoxib
- Phenoxybenzamine
- Phentolamine
- Phenylbutazone
- Piketoprofen
- Pioglitazone
- Piroxicam
- Pramlintide
- Pranoprofen
- Prazosin
- Proglumetacin
- Propyphenazone
- Proquazone
- Repaglinide
- Rofecoxib
- Rosiglitazone
- Salicylic Acid
- Salsalate
- Saxagliptin
- Sitagliptin
- Sodium Salicylate
- St John's Wort
- Sulindac
- Tamsulosin
- Tenoxicam
- Terazosin
- Tiaprofenic Acid
- Tolazamide
- Tolbutamide
- Tolfenamic Acid
- Tolmetin
- Trimazosin
- Urapidil
- Valdecoxib
- Vildagliptin
How much does Labetalol cost?
$13.75
Labetalol contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Labetalol will not be safe for you to take.
- Low heart rate (less than 60 beats/minute)
- Heart problems (e.g., greater than first-degree heart block, cardiac shock)
- Heart failure
- Uncontrolled or severe asthma
- Severe low blood pressure
What are alternatives to Labetalol?
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