Labetalol

Labetalol

1. About labetalol

Labetalol belongs to a group of medicines called beta blockers.

It's used to treat high blood pressure, including high blood pressure in pregnancy.

It can also be used to prevent chest pain caused by angina.

If you have high blood pressure, taking labetalol helps to prevent future heart disease, heart attacks and strokes.

This medicine is only available on prescription. It comes as tablets.

2. Key facts

  • Labetalol slows down your heart rate and makes it easier for your heart to pump blood around your body.
  • It's usual to take labetalol twice a day. Some people take it 3 or 4 times a day.
  • The main side effects of labetalol are feeling dizzy or weak, itchy skin, a rash or tingly scalp, and difficulty peeing. These usually happen at the start of treatment and are short-lived.
  • If you're pregnant, labetalol is the first choice of medicine for treating high blood pressure.
  • Do not stop taking labetalol suddenly, especially if you have heart disease. This can make your condition worse.
  • Labetalol is also known by the brand name Trandate.

3. Who can and can't take labetalol

Labetalol can be taken by adults. It can sometimes be prescribed for babies and children by a specialist.

It's not suitable for everyone. To make sure it's safe for you, tell your doctor before starting labetalol if you:

  • have had an allergic reaction to labetalol or any other medicine in the past
  • have liver or kidney problems
  • have low blood pressure or a slow heart rate
  • have heart failure that's getting worse, heart disease, or you have recently had a heart attack
  • have severe blood circulation problems in your arms and legs (such as Raynaud's), which may make your fingers and toes tingle or turn pale or blue
  • have a lung disease or asthma

4. How and when to take it

Adults and children aged 11 years and over usually take labetalol twice a day.

If you're on a high dose, you may need to take it 3 or 4 times a day.

Younger children usually take labetalol 3 or 4 times a day.

Try to space your doses out evenly throughout the day.

Important

Take labetalol even if you feel well, as you'll still be getting the benefits of the medicine.

Do not stop taking labetalol suddenly, especially if you have heart disease. This can make your condition worse.

If you want to stop taking your medicine, speak to your doctor. They may recommended reducing your dose gradually over a few weeks.

How much will I take?

The usual dose of labetalol for adults is between 400mg and 800mg a day, split into 2 doses.

If your blood pressure is still too high, your doctor may increase your dose up to 2,400mg a day.

If your child is prescribed labetalol, the doctor will use your child's age and weight to work out the right dose.

Will my dose go up or down?

You'll usually start on a low dose of 100mg, taken twice a day.

You doctor may increase your dose every 1 to 2 weeks if the medicine is not controlling your high blood pressure or angina.

Once you find a dose that works for you, you'll usually stay with the same amount.

How to take it

Take labetalol with food. It'll be less likely to upset your stomach.

Swallow the tablets whole with a drink of water, juice or milk. Do not chew them.

What if I forget to take it?

If you miss a dose of labetalol, take it as soon as you remember, unless it's nearly time for your next dose.

In this case, just leave out the missed dose and take your next dose as normal.

Never take 2 doses at the same time. Do not take an extra dose to make up for a forgotten one.

If you often forget doses, it may help to set an alarm to remind you.

You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

What if I take too much?

The amount of labetalol that can lead to an overdose varies from person to person.

Urgent advice: Call your doctor or go to A&E straight away if you take too much labetalol

Taking more than your prescribed dose can slow down your heart rate and make it difficult to breathe.

It can also make you feel drowsy or confused.

If you need to go to A&E, do not drive yourself. Get someone else to drive you.

Take the labetalol packet or the leaflet inside the packet, plus any remaining medicine, with you.

5. Side effects

Like all medicines, labetalol can cause side effects in some people, but many people have no side effects or only minor ones.

Side effects often improve as your body gets used to the medicine.

Common side effects

These common side effects happen in more than 1 in 100 people. They're usually mild and go away by themselves.

Talk to your doctor or pharmacist if the side effects bother you or last more than a few days:

  • feeling dizzy or weak
  • itchy skin or a rash
  • headaches
  • tingling scalp
  • difficulty peeing

Serious side effects

It does not happen often, but some people have serious side effects when taking labetalol.

Tell a doctor straight away if you have:

  • shortness of breath with a cough that gets worse when you exercise (like walking up stairs), swollen ankles or legs, chest pain and an irregular heartbeat - these are signs of heart problems
  • shortness of breath, wheezing and tightening of the chest - these can be signs of lung problems
  • yellow skin or the whites of your eyes turn yellow - these can be signs of liver problems

Serious allergic reaction

In rare cases, labetalol may cause a serious allergic reaction (anaphylaxis).

Immediate action required: Call 999 or go to A&E if:

  • you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
  • you're wheezing
  • you get tightness in the chest or throat
  • you have trouble breathing or talking
  • your mouth, face, lips, tongue or throat start swelling

You could be having a serious allergic reaction and may need immediate treatment in hospital.

These are not all the side effects of labetalol.

For a full list, see the leaflet inside your medicine packet.

Information:

You can report any suspected side effect to the UK safety scheme.

6. How to cope with side effects

What to do about:

  • feeling dizzy or weak - if labetalol makes you feel dizzy or weak, stop what you're doing and sit or lie down until you feel better. Do not drive or use tools or machinery if you're feeling dizzy. Do not drink alcohol as it'll make you feel worse. Talk to your doctor if you feel dizzy all the time or this side effect lasts longer than a week.
  • itchy skin or a rash - put a cold compress on the itchy area (you can make your own by wrapping a bag of frozen food in a towel). Have a shower or bath with cool or lukewarm water. You could also take an antihistamine, which you can buy from a pharmacy. Check with the pharmacist to see what type is suitable for you. Speak to your doctor if the itchiness or rash gets worse or it lasts for more than a week.
  • headaches - make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller. Headaches usually go away after the first week of taking labetalol. Talk to your doctor if the headaches last longer than a week or are severe.
  • tingling scalp - this should wear off in the first week or two as your body adjusts to the medicine. Talk to your doctor if this bothers you or does not go away. They may try you on a lower dose and then increase it gradually to a full dose.
  • difficulty peeing - if this happens to you, speak to your doctor as soon as possible.

7. Pregnancy and breastfeeding

It's important to treat your high blood pressure during pregnancy. This will help you and your baby to stay healthy.

Talk to your doctor about the best treatment for your high blood pressure.

If your doctor recommends labetalol during your pregnancy, they'll prescribe the lowest dose that works for you.

Labetalol is not thought to harm an unborn baby. But there's a small chance that when your baby's born the medicine can affect their blood sugar levels.

For this reason your baby may be monitored for the first 24 hours to make sure everything is OK.

For more information about how labetalol can affect you and your baby during pregnancy, read this leaflet on the best use of medicines in pregnancy (BUMPS) website.

Labetalol and breastfeeding

If your doctor or health visitor says that your baby is healthy, it's OK to take labetalol while breastfeeding.

Labetalol passes into breast milk in very small amounts. It's unlikely to cause any side effects in your baby.

It's important to treat your high blood pressure to keep you well. Breastfeeding will also benefit both you and your baby.

If your baby's not feeding as well as usual, seems unusually sleepy, or you have any other concerns about them, talk to your doctor or health visitor.

Non-urgent advice: Tell your doctor if you're:

  • trying to get pregnant
  • pregnant
  • breastfeeding

8. Cautions with other medicines

There are some medicines that may interfere with the way labetalol works.

Tell your doctor if you're taking:

  • other medicines for high blood pressure - when taken together with labetalol, this can sometimes lower your blood pressure too much; which may make you feel dizzy or faint. If this keeps happening to you, tell your doctor. They may change your dose.
  • other medicines that can lower your blood pressure - these include some antidepressants, nitrates (for chest pain), baclofen (a muscle relaxant), medicines for an enlarged prostate, like tamsulosin, or medicines for Parkinson's disease, such as co-careldopa and levodopa
  • medicines for your heart, such as amiodarone, flecainide or digoxin
  • non-steroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen - they can stop labetalol working properly
  • medicines for diabetes, particularly insulin - labetalol may make it more difficult to recognise the warning signs of low blood sugar. Speak to your doctor if you have low blood sugar levels without getting any of the usual warning signs. You should check your blood sugar after exercise, and follow the usual advice about checking it before driving or operating machinery.
  • steroids like prednisolone
  • cough medicines that contain pseudoephedrine or xylometazoline
  • medicines for allergies, such as ephedrine, noradrenaline or adrenaline
  • medicines for asthma or chronic obstructive pulmonary disease (COPD)

Mixing labetalol with herbal remedies or supplements

There might be a problem taking some herbal remedies and supplements together with labetalol, especially ones that cause side effects like low blood pressure.

Important

Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements.

9. Common questions

Page last reviewed: 22 March 2019
Next review due: 22 March 2022