Labetalol

Should be taken with food. Take immediately after meals.

Cardiogenic shock, sick sinus syndrome (including sino-atrial block), 2nd- or 3rd-degree heart block, Prinzmetal's angina, severe bradycardia (<45-50 bpm), uncompensated heart failure, overt heart failure; uncontrolled, incipient or digitalis-refractory heart failure; current or history of bronchospasm and bronchial asthma, history of obstructive airway disease, untreated phaeochromocytoma, metabolic acidosis, severe peripheral circulatory disturbances, hypotension, other conditions associated with severe and prolonged hypotension. Labetalol IV infusion should not be used to control hypertensive episodes after myocardial infarction when peripheral vasoconstriction suggests low cardiac output.

Patient with 1st-degree heart block, compensated heart failure, poor cardiac reserve, peripheral circulatory disorders (Raynaud's disease, intermittent claudication), phaeochromocytoma, diabetes mellitus, thyroid disease, history of psoriasis, myasthenia gravis, history of severe anaphylaxis to allergens. Patients requiring anaesthesia, or those undergoing surgery (including cataract surgery). May mask signs of hyperthyroidism (e.g. tachycardia) and acute hypoglycaemia. Avoid abrupt withdrawal, particularly in patients with ischaemic heart disease. Hepatic or renal impairment. Elderly. Pregnancy and lactation. Patient Counselling This drug may cause dizziness or fatigue, if affected, do not drive or operate machinery. Monitoring Parameters Monitor blood pressure and heart rate before and after the 1st dose and during dose changes; hepatic function periodically; glucose levels in patients with diabetes mellitus. Perform close pulse, cardiac, and blood pressure monitoring during and after completion of IV inj or infusion.

Significant: Bradycardia, CHF, symptomatic hypotension (with or without syncope), postural hypotension, bronchospasm; exacerbation of angina, ventricular arrhythmia and MI (following abrupt withdrawal); may precipitate or aggravate symptoms of arterial insufficiency (in patients with peripheral circulatory disorders or Raynaud's disease); induction or exacerbation of psoriasis, dry eyes, anaphylactic reactions. Cardiac disorders: Rarely, heart block. Ear and labyrinth disorders: Vertigo. Eye disorders: Impaired vision. Gastrointestinal disorders: Nausea, vomiting, diarrhoea, epigastric pain, dyspepsia, dysgeusia. General disorders and administration site conditions: Fatigue, asthenia, drug fever, lethargy. Hepatobiliary disorders: Jaundice, hepatitis. Investigations: Increased serum creatinine, BUN, and LFTs; positive antinuclear antibodies unassociated with disease. Musculoskeletal and connective tissue disorders: Cramps, toxic myopathy. Nervous system disorders: Headache, dizziness, drowsiness, tremor, paraesthesia. Psychiatric disorders: Confusion, sleep disturbance, nightmares, depressed mood. Renal and urinary disorders: Urinary retention, difficulty in micturition. Reproductive system and breast disorders: Ejaculatory failure, impotence, nipple pain. Respiratory, thoracic and mediastinal disorders: Nasal congestion, dyspnoea. Skin and subcutaneous tissue disorders: Hyperhidrosis, rash, tingling sensation in the scalp, reversible lichenoid rash, SLE, reversible alopecia. Vascular disorders: Peripheral coldness.
Potentially Fatal: Rarely, severe hepatocellular injury (reversible).

Enhanced hypotensive effects with ACE inhibitors, angiotensin-II antagonists, aldesleukin, alprostadil, anxiolytics, hypnotics, diuretics, α-blockers, TCAs, phenothiazines, and barbiturates. May cause the attenuation of reflex tachycardia and increased risk of hypotension with anaesthetics. May enhance the hypotensive effects of halothane. NSAIDs, corticosteroids, estrogens and progesterones may antagonise the hypotensive effects of labetalol. May result in bradycardia and hypertension when given with epinephrine. Labetalol may blunt the reflex tachycardia produced by glyceryl trinitrate. May enhance the blood glucose-lowering effects of insulin and oral antidiabetic agents. May increase the risk of hypotension with dihydropyridine Ca antagonists (e.g. nifedipine). May cause hypotension, bradycardia and asystole with verapamil and diltiazem. May increase the atrioventricular conduction time with digitalis glycosides. May increase the rebound hypertensive effect of clonidine (when abruptly withdrawn). Class I antiarrhythmic agents (e.g. disopyramide, quinidine) and amiodarone may potentiate the effects on atrial conduction time and induce negative inotropic effect. Bioavailability may be increased with cimetidine and hydralazine. May increase the incidence of tremors with TCAs. May increase the risk of bradycardia with antimalarials (e.g. quinine, mefloquine). Labetalol may increase the vasoconstricting effects of ergot derivatives.

Beta-Blockers

C07AG01 - labetalol ; Belongs to the class of alpha and beta blocking agents. Used in the treatment of cardiovascular diseases.