ADULT MEDICATION GUIDELINE

Labetalol Injection
Scope (Staff): All WNHS Staff
Scope (Area): Obstetrics and Gynaecology
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Pregnancy and
Dose Administration Monitoring
Breastfeeding

Restrictions
Formulary: Restricted

HIGH RISK Medication

Medication Class
Beta blocker

Presentation
Ampoule: 50mg/10mL

Storage
Store at room temperature, below 25°C
Ampoule: Protect from light. Schedule 8 Medication
Infusion solution: Discard after 6 hours if kept below 25 °C or after 24 hours if kept between 2 to
8 °C. Do not freeze.

Dose

Acute treatment of severe hypertension in pregnancy

IV injection: 20mg labetalol (4mL) undiluted over 2 minutes. Dose can be repeated every 10
minutes (titrated to blood pressure) to a maximum of 4 doses of 20mg (80mg = 16mL).

If 2 bolus doses are insufficient to control blood pressure, consider IV therapy via infusion.

The maximal effect usually occurs within 5 minutes of each dose.

 Labetalol Injection – Adult

IV infusion: See below

Maximum total 24 hours dose is 300mg (injection plus infusion)

Administration

IV injection

Inject undiluted solution slowly over 2 mins.

IV infusion
Step 1 Dilution:
Withdraw 40mL sodium chloride 0.9% from a 100mL bag of sodium chloride 0.9%. Draw up
200mg labetalol (40 mL) and add to remaining 60 mL in the bag of sodium chloride 0.9%. Final
concentration is 2 mg/mL.

Step 2 Administration:
Start infusion pump at 10 mL/hour (20 mg/hour). Titrate to stabilise blood pressure by adjusting
(doubling, maintaining or halving) the infusion as required every 15 to 30 minutes to a maximum
dose of 80 mL/hour (160 mg/hour).

Discontinue by weaning over 1-2 hours when clinically appropriate.

Monitoring

Blood pressure and heart rate should be monitored during and every 15-30 mins following IV
administration until stabilised, then record hourly as clinically appropriate.

Patients should always be kept in a supine position during and for up to 3 hours post IV
administration due to potential orthostatic hypotension

Pregnancy
1st Trimester: Considered safe to use
2nd Trimester: Monitoring required
3rd Trimester: Monitoring required

Breastfeeding
Considered safe to use

Related Policies, Procedures & Guidelines

WNHS Clinical Practice Guidelines:

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 Labetalol Injection – Adult

Hypertension in pregnancy: Medical management

Hypertension in pregnancy – midwifery care
WNHS Pharmaceutical and Medicines Management Guidelines:
Medication Administration

References
Society of Hospital Pharmacists of Australia. Labetalol. In: Australian Injectable Drugs
Handbook [Internet]. [St Leonards, New South Wales]: Health Communication Network; 2022
[cited 2023 Feb 14]. Available from: http://aidh.hcn.com.au
The Royal Women's Hospital. Labetalol. In: Pregnancy and Breastfeeding Medicines Guide
[Internet]. Parkville (Victoria): The Royal Women's Hospital; 2022 [cited 2023 Feb 14].
Available from: https://thewomenspbmg.org.au/
Lowe SA, Bowyer L, Lust K, McMahon LP, Morton MR, North RA, et al. Guideline for the
management of hypertensive disorders of pregnancy. Society of Obstetric Medicine of
Australia and New Zealand (SOMANZ) Endorsed Guidelines [Internet]. 2014 [cited 2023 Mar
10]. Available from: Guideline for the Management of Hypertensive Disorders of Pregnancy
South Australian Maternal, Neonatal & Gynaecology Community of Practice. Hypertensive
Disorders in Pregnancy. South Australian Perinatal Practice Guidelines. [Internet]. 2020 [cited
2023 Feb 14]. Available from: Hypertensive Disorders in Pregnancy (sahealth.sa.gov.au)
Ballarat Health Services. Labetalol (Intravenous - severe hypertension in pregnancy). Ballarat
Health Services Drug Guideline DRG0035 [Internet]. 2020 [cited 2023 Mar 15]. Available from:
gddrg0035-25948-63478.pdf (bhs.org.au)
3centres Collaboration Consensus Guideline – Hypertension in Pregnancy, Preeclampsia and
Eclampsia. [Internet] 2012 [cited 2020 Jun 10]. Available from:
www.pers.org.au/Assets/45/1/3CENTRESPREECLAMPSIA.pdf
McEvoy GK et al. Handbook on Injectable Drugs (Trissel): Labetalol hydrochloride. American
Society of Health System Pharmacists. [Internet]. 2018. [cited 2020 Jun 10].

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 Labetalol Injection – Adult

Keywords Labetalol injection, Labetalol SXP, hypertension

Document Chief Pharmacist
Owner:
Author/ KEMH Pharmacy Department
Reviewer
Version 5.0
Info:
Date First May 2015 Last Reviewed: 14/02/2023 Review Date: 14/02/2026
Issued:
Endorsed Medicines and Therapeutics Committee Date: April 2023
by:
NSQHS
Standards Std 1: Clinical Governance Std 5: Comprehensive Care
Applicable:
Std 2: Partnering with Consumers Std 6: Communicating for Safety

Std 3: Preventing and Controlling Std 7: Blood Management

Healthcare Associated Infection

Std 4: Medication Safety Std 8: Recognising and

Responding to Acute Deterioration
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