Alpha- and beta-blocker
ATC code: C07AG01 (Labetalol)
Competitive blocker of beta-1, beta-2, and postsynaptic alpha-1 receptors. Beta:alpha blockade ratio approximately 7:1 orally and 3:1 IV. Lowers BP via reduced peripheral resistance without significant reflex tachycardia. Onset 30-60 min orally, peak 1-2 h. T½ 6-8 h.
First line
Hypertension during breastfeeding. 2020 and SEGO 2023 – drug of choice. RID 0.2-0.6%, no milk-supply effect. Advantages over methyldopa: no maternal sedation or depression. No clinically significant bradycardia reported in breastfed infants.
First line
Hypertension in pregnancy and preeclampsia. Per 222 (2020), NG133 2019, and SEGO 2023, first-line alongside methyldopa and nifedipine. Dose 100-200 mg 2-3 times daily, max 2400 mg/day. For acute severe hypertension/preeclampsia – IV 20 mg bolus, escalating 40-80 mg every 10-20 min up to 300 mg.
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Safe. Drug of choice in any trimester.
Fully compatible. Hale L2. RID 0.2-0.6%. No infant bradycardia in breastfed babies.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Labetalol is evaluated for the following indications with varying evidence strength: Hypertension in pregnancy (evidence tier A), Hypertension during breastfeeding (evidence tier A). See the full indication matrix with dosing and citations above on this page.
Common side effects of Labetalol (≥ 1 in 100): Fatigue, Dizziness, Orthostatic hypotension, Nausea, Scalp pruritus (characteristic). See the Safety section for uncommon and serious reactions.
FDA category C. Safe. Drug of choice in any trimester.
Fully compatible. Hale L2. RID 0.2-0.6%. No infant bradycardia in breastfed babies.
Labetalol is contraindicated in: Hypersensitivity; Asthma and severe COPD; Bradycardia <50, 2nd-3rd degree AV block; Cardiogenic shock; Decompensated heart failure. Full list in the Safety section.