Labetalol

Pregnancy & gynaecology-specific. Every dose row is source-referenced; verify against institutional protocols.

LabetalolEMERGENCY KITAlpha-beta blocker antihypertensive

Guideline conflict

India NHM CEmONC, chapter 4 — prose
20 mg, then 40 mg, then 80 mg at 10-minute reassessments; further dosing may reach a cumulative 300 mg.

Same NHM chapter — adjacent flowchart
Stops the displayed 20 → 40 → 80 mg sequence at a stated 140 mg maximum.

Population/setting difference: Same emergency setting; the flowchart and prose show different stopping points.

Practical India consideration: Use the approved local sequence and track every previous IV dose. Persistent severe BP needs senior/anaesthetic involvement.

App default: The card records the prose ceiling of 300 mg; persistent severe BP after the initial 140 mg sequence requires senior reassessment before additional doses or another agent.
Reason: A cumulative ceiling is not an instruction to continue dosing without reassessing treatment failure and contraindications.

Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.

Labetalol: indication-specific regimens
Indication	Dose	Route	Frequency	Duration / preparation	Maximum	Monitoring / cautions
Persistent severe hypertension in pregnancy or postpartum (systolic ≥160 OR diastolic ≥110 mmHg) Government of India, MoHFW / NHMchecked	20 mg over 2 min; reassess at 10 min, then 40 mg; further 80 mg doses at 10-min intervals if severe BP persists	IV bolus	10-minute reassessment and dose sequence	Acute control, then change to an appropriate oral regimen · 5 mg/mL stock: 20 mg = 4 mL, 40 mg = 8 mL, 80 mg = 16 mL. Give each dose slowly, record cumulative dose and check the stock strength	300 mg cumulative in the cited Indian CEmONC regimen; seek escalation before continuing beyond it	Monitor Check BP and pulse before and after each acute dose; fetal monitoring when appropriate Persistent severe BP despite the initial sequence requires senior/anaesthetic review, a different agent and HDU-level monitoring; avoid uncontrolled stacking Contraindications / cautions Asthma, bradycardia/heart block or decompensated heart failure
Maintenance hypertension during pregnancy/postpartum MSFchecked	Start 100 mg twice daily; increase by 100–200 mg increments according to BP; higher daily doses divided three times daily	Oral	Twice daily initially; three divided doses if higher doses needed	Continue while clinically required; titrate down rather than stop abruptly, with a postpartum review plan · 100 mg or 200 mg tablets; prescribe the strength, dose and administration times	2400 mg/day	Monitor BP/heart rate, postural symptoms; neonatal glucose/heart-rate observation after late-pregnancy exposure Contraindications / cautions Asthma, heart block, marked bradycardia, decompensated heart failure

Pregnancy safety

First-line across guidelines

Lactation

Compatible (low milk transfer)

Adverse effects

Bradycardia, hypotension, bronchospasm, neonatal hypoglycaemia late use

Government of India, MoHFW / NHMcheckedIN REVIEW