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Al-Shifa Hospital Cardiac Cath. Department: Labetalol Hydrochloride 5mg/ml Solution For Injection

This document provides dosing instructions for Labetalol Hydrochloride 5mg/ml Solution for Injection. It recommends an initial IV dose of 20 mg over 2 minutes for hypertension, with additional 40-80 mg doses every 10 minutes up to 300 mg total. It also provides instructions for continuous IV infusion starting at 2 mg/min up to 160 mg/hr. Side effects of overdose include bradycardia, hypotension, and bronchospasm. Treatment for overdose includes atropine for bradycardia, fluids and catecholamines for hypotension, and glucagon or calcium if needed.

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109 views2 pages

Al-Shifa Hospital Cardiac Cath. Department: Labetalol Hydrochloride 5mg/ml Solution For Injection

This document provides dosing instructions for Labetalol Hydrochloride 5mg/ml Solution for Injection. It recommends an initial IV dose of 20 mg over 2 minutes for hypertension, with additional 40-80 mg doses every 10 minutes up to 300 mg total. It also provides instructions for continuous IV infusion starting at 2 mg/min up to 160 mg/hr. Side effects of overdose include bradycardia, hypotension, and bronchospasm. Treatment for overdose includes atropine for bradycardia, fluids and catecholamines for hypotension, and glucagon or calcium if needed.

Uploaded by

Iyas Jehad
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Al-Shifa Hospital ‫مجمع الشفاء الطبي‬

Cardiac Cath. Department ‫قسم قسطرة القلب‬

Labetalol Hydrochloride 5mg/ml Solution for Injection


Parenteral: Repeated IV Injection:
Initial dose:
20 mg (0.25 mg/kg) by slow IV injection over a 2 minute period.
Additional injections of 40 to 80 mg can be given at 10 minute intervals until a
desired supine blood pressure is achieved or a total of 300 mg of labetalol has
been injected.

Slow continuous IV Infusion:


Add 40 mL of labetalol Injection to 160 mL (5% Dextrose or
0.9% Sodium Chloride), of a commonly used IV fluid such that the resultant 200
mL of solution contains 200 mg of labetalol, 1 mg/mL. The diluted solution
should be administered at a rate of 2 mL/min to deliver 2 mg/min.
In the hypertension of pregnancy: The infusion can be started at the rate of 20mg
per hour and this dose may be doubled every thirty minutes until a satisfactory
reduction in blood pressure has been obtained or a dosage of 160 mg per hour is
reached. Occasionally, higher doses may be necessary.
In hypertensive episodes following acute myocardial infarction: The infusion
should be commenced at 15mg per hour and gradually increased to a maximum of
120 mg per hour depending on the control of blood pressure.
In hypertension due to other causes: The rate of infusion of labetalol
hydrochloride should be about 2mg (2ml of infusion solution) per minute, until a
satisfactory response is obtained; the infusion should then be stopped. The
effective dose is usually in the range of 50-200mg depending on the severity of the
hypertension. For most patients it is unnecessary to administer more than 200mg
but larger doses may be required especially in patients with phaeochromocytoma.
The rate of infusion may be adjusted according to the response, at the discretion of
the physician. The blood pressure and pulse rate should be monitored throughout
the infusion

Contraindications
• Cardiogenic shock.
• Uncontrolled, incipient or digitalis refractory heart failure.
• Sick sinus syndrome (including sino-atrial block).
• Second or third degree heart block.
• Prinzmetal's angina.
• History of wheezing or asthma.
• Untreated phaeochromocytoma.
• Metabolic acidosis.
• Bradycardia (<45-50 bpm).
• Hypotension.
• Hypersensitivity to labetalol.
• Severe peripheral circulatory disturbances.
Overdose
Symptoms of overdosage are bradycardia, hypotension, bronchospasm and acute
cardiac insufficiency.
After an overdose or in case of hypersensitivity, the patient should be kept under
close supervision and be treated in an intensive-care ward. Artificial respiration
may be required. Bradycardia or extensive vagal reactions should be treated by
administering atropine or methylatropine.
Hypotension and shock should be treated with plasma/plasma substitutes and, if
necessary, catecholamines. The beta-blocking effect can be counteracted by slow
intravenous administration of isoprenaline hydrochloride, starting with a dose of
approximately 5mcg/min, or dobutamine, starting with a dose of approximately
2.5mcg/min, until the required effect has been obtained.
If this does not produce the desired effect, intravenous administration of 8-10 mg
glucagon may be considered. If required the injection should be repeated within
one hour, to be followed, if necessary, by an iv infusion of glucagon at 1-3mg/hour.
Administration of calcium ions, or the use of a cardiac pacemaker, may also be
considered.
Oliguric renal failure has been reported after massive overdosage of labetalol
orally. In one case, the use of dopamine to increase the blood pressure may have
aggravated the renal failure.

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