Blood pressure and rate control
Labetalol (Trandate) drip
Trandate
Dosing
| Start | 0.5–2 mg/min, or 20 mg IV push then 20–80 mg every 10 minutes |
|---|---|
| Titrate | By blood pressure |
| Maximum | 300 mg total (label) |
| Common bags | 200 mg in 200 mL (1 mg/mL); 500 mg in 250 mL (2 mg/mL) |
| Dose units | mg/min, mg/h |
Line and administration
- Peripheral or central
Watch for
- Bradycardia and heart block
- Bronchospasm
- Avoid in decompensated heart failure
Labetalol: full drug monographIndications, mechanism, pharmacokinetics, cautions and every dose the app lists.
In the one-pagers
- Aortic Dissection and Hypertensive EmergencyAortic dissection: Beta-blocker FIRST (esmolol or labetalol), then a vasodilator (nicardipine, clevidipine or nitroprusside) if BP stays high
- Subarachnoid HemorrhageUntil the aneurysm is secured: BP: frequent checks; nicardipine, clevidipine or labetalol; avoid MAP below 65 and swings. No proven target; many units keep SBP below 160, some below 140 (ESO 2026 consensus: about 160, lowered gradually).
- Obstetric EmergenciesPreeclampsia and eclampsia: Labetalol IV: 20 mg over 2 min: 40 mg, then 80 mg every 10 min; max 300 mg
- Endocrine EmergenciesPheochromocytoma crisis: Lower pressure with α-blockade or an arterial vasodilator: phentolamine 1–5 mg IV boluses or infusion, nicardipine, clevidipine or nitroprusside. Add esmolol for tachycardia only after α-blockade; labetalol alone is a poor choice because its IV β effect is about 7 times its α effect. Patients are volume-contracted, so expand volume as vessels relax. Catecholamine cardiomyo
- Peripheral Vascular EmergenciesCarotid endarterectomy and stenting in depth: Hyperperfusion syndrome: after a tight stenosis is opened, flow can exceed what the brain's autoregulation can handle. Signs are a severe headache on the operated side, eye or facial pain, seizures, focal deficits and confusion, usually with high blood pressure; intracerebral hemorrhage is the feared result. In the review by Zhou et al., pooled inciden
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Other blood pressure and rate control
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For education and exam preparation only. Follow your institution’s protocols. Study aid: check every dose against the order, the bag label, your pump library and your institution's protocol.