Labetalol Puns

Husband posting for my wife as I am the redditor in the family! She is currently 8w2d with what we hope to be our second child (4th pregrnancy). She has always had white-coat syndrome in any doctors office-getting a higher than normal blood pressure when in the office. With our daughter she got a blood pressure machine and took her bp multiple times a day in the third trimester. In weeks 36 it did start to creep up in the 130s/90s at home and she was induced 37w5d. The doctors were worried because in the office she would get 150+/high 90s. That was a little over two years ago. Anyways, we went to our 8 week appt and she was 155/97 (this was on both her bp cuff and the offices - so we know hers is accurate) and the doctors are really pushing her to take labetalol. She has now upped her at home bp measuring and is consistently 120/80 +/-3 in each direction, one exception was she took it immediately after doing some yard work and was little out of breath and got 130/83. My wife thinks the dr is not taking her white-coat syndrome seriously and thinks my wife is just anti-meds. So our questions are

1. Anyone with very mild bp issues take labetalol during pregnancy? If so how did it go and were you babies fine?

2. Anyone else struggle with high bp in the office and their doctors not believing their white coat syndrome

3. Anyone take the meds and have their bp drop too much?

tldr: high bp in office, but fine at home, dr pushing labetalol

I'm in a Suboxone telehealth program and have been for about 7 months. Last month I started on Labetalol for high blood pressure.(It was 188/107 Yikes.) Both of my tests have come back as false positives for fentanyl since. Its not really an issue with my provider since the confirm comes back below cutoff/negative, but I can't find any literature on it other than it could cause a false positive for amphetamines. I haven't changed anything else that I take. (I do take diphenhydramine to sleep but its never caused a false positive.) Any help or links are appreciated. Thanks!

So I’m currently 22 & 1

Last week I was put on labetalol due to having two elevated readings at the end of august and the end of September 140/80 & 148/88 (anatomy scan I was super anxious) However they just pulled me off of the medication because my top number when taking my blood pressure has been 118-114 . The medication also made me feel kinda foggy. My Ob said we will resume medication if my numbers are higher like 150/90. I just feel unsure of this and was wondering if anyone has experienced higher numbers in the first trimester and then a sudden drop ? I haven’t been on the medication for 24 hours and my BP Is still in good range. I guess I’m just nervous that I’m a few days it will spike back up again.

I have extremely high blood pressure. Like, stroke high. My mother had very high blood pressure from an early age and had a heart attack at 42. Unfortunately, she has passed her hbp on to me. Needless to say, my bp is my priority. It took me four months to adjust to the carvedilol, it was hell. But it works great now. I am running low on my Rx and believed I needed to up my dose. I also needed a new Dr.

After my first appt with a new Dr, he called in a new prescription for labetalol. He provided no explanation so I messaged him and asked what the benefits were of labetalol over the carvedilol I’m currently on. His response was that I am of childbearing age. That’s it. Not that the labetalol works better but that I might change my mind about having children and that is apparently more important? (I informed him I was not wishing to get pregnant and do not wish to have children. )

I’m concerned he is prioritizing my uterus over my extremely high blood pressure. I was hoping someone here might provide some insight on the labetalol and whether or not it works well for them. I’ve tried to look up how these two medications compare to one another and I’m concerned as the few studies I read found that carvedilol works better. I don’t have insurance so I don’t have money to “Dr. hop” or get a second opinion and I’m going to run out of my carvedilol soon so I may have no choice but to move forward with labetalol.

Any advice, help, or personal experiences provided would be greatly appreciated!

I am 1 month pp, and my milk supply is not very high. I am pumping around the clock, sometimes 1 hour sessions and other times 30 mins. Even through my long pump sessions I only on average will pump about 50 ml. I do not know why my supply is so low, I am otherwise very healthy. I had a super healthy pregnancy. Only thing is that post partum, I developed really high blood pressure and had to take a medication called labetalol for 4 weeks. I really want to be done exclusively pumping and go back to nursing — I am desperate! But I am wondering— would labetalol be causing a low milk supply? I really want to make sure I am feeding my baby enough. Has anyone else had experience with labetalol while nursing? Did you have any supply issues?

I’m 10 days PP and have had a few high BP readings, once at urgent care the other night (144/90) and then I was having chest pain yesterday evening so my OB office sent me to the ER. Full work up was clear but my BP was high, 174/110 when I checked in and then it did drop and average out in the 140s/80s.

Went to my OB today and it was 140s/80s. She prescribed me 100mg of labatelol twice a day. I’m also have some anxiety that we talked about but decided not to start two medicines at once. I know I need to start my new BP medicine but I’m so scared for side effects (anxiety speaking, I know I need to take my medicine). Anyone have any experience with this medicine and the side effects? TIA I’m a real mess at the moment.

My OB prescribed 100mg 3x daily as a migraine preventative during pregnancy. I just started it today as I just got a positive test this morning! She kept saying I wouldn’t like it and I assumed she meant because it’s not that great at migraine prevention. But now I’m reading about side effects online and thinking that’s the problem. What was your experience with this medication?

So I’ve (35F) recently been diagnosed with postpartum hypertension and am on labetalol. My dr told me to lower my salt intake and without checking, I used a salt replacement in a meal today. I need some reassurance that using it once won’t raise my potassium levels to anything dangerous.

i found a research anout labetalol is used to soften meth overdoses preferrably over benzos

Anyone takes some betablock before stims to reduce vesicular damaage?

So after a slightly turbulent labor and postpartum period I'm curious about others' experiences in these areas.

My concern lies in me not having taken this medication for the past 6 days and I'm still kind of suspicious every day the high BP will come back.

I stopped taking it (also family doctor wanted me to at some point) because my blood pressure was consistently too low and it was affecting me too much. It remained low/normal without the med but I also don't have that 'too low' feeling without the med, which is good.

After the high BP returned some days after labor I read the hypertension could last from 2-12 weeks postpartum so that's why I'm feeling a bit apprehensive about whether it's really this low/normal or it's still the meditation.

Had an interesting question in Uworld - hypertensive emergency 211/105. The question then asked what drug does the follow:

Stroke volume unchanged

Systemic vascular resistance decreased

Heart rate decreased

I understand how labetalol can decrease SVR (vasodilation) and heart rate (B1 blocking) but how does stroke volume stay the same? I thought it would down* up given the B1 blocking?

I’ve been prescribed labetalol off label for anxiety for years, even though I barely touch it. Counted out the pills today and I have >700g atm, so enough to actually do something with this. It’ll be a few years until I have the experience to do anything but think about the possibilities, but do you guys have anything in mind?

Here is the chemical in question, when it’s inverted I see what I hope is potential at least haha. Thanks for any ideas you guys might have, I’ll sit on this stuff forever if I can’t think of anything

I’m almost 7w and I was on Metoprolol for about 3 years. My PCP switched me to Labetalol on Monday seeing as it is safer for pregnancy. Holy shit. I can’t sleep, I’m fidgeting, I’m ITCHY, I’m anxious. I don’t know what the hell to do. I called her today because I refuse to take this any longer. I haven’t slept since Sunday. It’s brutal. Anyone else have any issues (or luck) with this? I’ve always had high BP...even when I was a little kid, healthy, small, playing sports it always ran about 145/80. So high bp is ‘normal’ to me. I’m just having a hard time with this medicine and I need to hear that it either gets better or it’s all in my head.

So it turns out I have preeclampsia (I'm being induced tomorrow!). My OB prescribed me labetalol today to bring my blood pressure down. I took one this evening, and about an hour later my nipples were in excruciating pain. I literally screamed at my husband to grab me a knife so I could cut them off, lol. It felt like the pain I get in my nipples when I'm cold, except 100x worse. I ended up googling labetalol and nipple pain, and it turns out that this is actually a (rare) side effect.

I just wanted to give other people a heads up in case this happens to you, because it's horrible, but I was able to make it go away. I just wrapped myself in a warm blanket and hugged a hot water bottle to my chest and I felt relief in less than a minute.

As summer nears, I am dreading the sun. I’m ready for spring, but not the blazing hot sun. I am finally ready to admit that the sun is a huge trigger for me. This is hard because I have 2 boys that love to play sports and swim, etc. Plus, my husband loves the beach. We rarely go, but I have agreed to vacation there this summer. It’s so hard when no one understands. It’s sunny and 65 degrees today and I was out for 20 mins and it triggered me. It’s sucks so much. I wore my sun glasses but dumb me didn’t put my hat on.

I’m not taking any preventatives. My doc has recommended labetalol, but I’ve yet to try it. Has anyone here used it? I’m always worried about side effects. I’m trying to maintain an exercise routine, but I heard the meds can cause fatigue and dizziness. I wonder if those are temporary, until you get used to it, or always? I’ve also heard of anti-seizure or anti-depressants being used. Thoughts on those?

Also, would you know if these prevent sun-related migraines? Especially at the beach, where we will be outside a lot.

Many thanks!

I noticed that when I take it, it’ll last pretty well until about 9 hours in, and my bp starts creeping up again until next dose at 12 hours.

Hi! I am currently 36 weeks and a few days and have just been put on Labetalol for high bp. After 2 doses my bp is still high and where it has been the past few weeks. I feel super dizzy and generally out of it. Has anyone taken this drug and not had any progress made on their bp? How long did it take for it to work for you? Thanks again!

So apparently my body doesn't handle pregnancy well and my BP is already really high at only 13 weeks. My Dr. prescribed labetalol - 100mg 2x a day. I am pretty upset as this is a category C drug. Meaning there could be risks to my little. I'm just so upset. I cant stop thinking that maybe trying for another was a selfish idea...

Anyone else been prescribed a bp med while pregnant?

I recently finished my rotation on a medicine ward. On the last day, I was on rounds with the residents/med students and we had a pregnant lady admitted for acute hepatitis. They talked about potential causes and investigations, we told them to be careful about upping her morphine too much due to her hepatic impairment, and we carried on. Looking at her home meds, she wasn't on very much, just labetalol that was started a few weeks ago for her hypertension and a prenatal multivitamin.

Later that afternoon, I was heading down to meet my preceptor when I overheard the residents talking about a hepatology consult that mentioned labetalol being a probable cause. I didn't have time to stick around but was actively thinking about it when I met with my preceptor. I found a good article on LiverTox (http://livertox.nih.gov/Labetalol.htm) through a quick search that summarizes all the case reports that have been reported. Although pretty rare, the patient's time course fits with what's described in the article. FYI: labetalol apparently has the most concern for hepatotoxicity of the beta-blockers.

I felt kind of discouraged for not adding it to the ddx; normally, I would've done a search on my phone during rounds for this kind of thing. I remember our academic dean telling us that it is our job to rule out drugs as a cause for a patient's problem. A little disappointing that I didn't do my due diligence, I guess.

Anyway, I thought about other options we could have given our patient and decided that nifedipine was probably the way to go if an antihypertensive was still needed (hepatotoxicity relatively more of a concern with methyldopa and labetalol). I headed back to the ward and asked the residents what the update was. Turns out they already d/c'd the labetalol and started them on nifedipine as per the consult. I didn't get to make the intervention, but I was able to let them know about the hepatotoxicity concerns with other first-line antihypertensives and gave them a copy of the labetalol article I had when they asked for the resource.

I had a lot of successful interventions while on my rotation, which was great and my experience there only confirmed that I want to go into hospital, but I guess I wanted to share this "failure" with pharmareddit. I don't really have a question. Maybe some words of wisdoms for a soon-to-be graduate?

So, nonselective alpha and beta blockers like labetalol decrease SVR and non selective beta blockers like nadolol increase SVR. Is this because of beta2 blockade in nadolol and alpha1 blockade in labetalol ? Am I right to infer this ?

Labetalol changes its affinity for alpha and beta receptors based on the route that it is administered. I am wondering if there are other drugs out there that have different pharmacology based on their route of administration?

Doc put me on a 100mg 2x/day regimen. Since starting it, my tongue is raw. I miss tasting things :( It feels like I burnt it on a really hot cup of soup.

Just wondering if anyone else was put on it for high BP, and if they have felt the same way?

I’m 31+3 on twice daily Adalat and Labetalol. Labetalol is slowly being increased as my bp gets harder to control. As of now I feel like I’m a growth on the couch existing just to eat, pee, and sleep.... And somehow they want me to exercise - ha!

Anyone else living the dream?

Is it possible for labetalol to drop BP too quickly and result in cerebral ischemia?

Ran a call the other day for a 60ish woman chief complaint of heart palpitations. She vaped some weed (or whatever the cool kids are doing these days) and shortly after began experiencing a rapid heart rate, mild SOB, and tingling in her hands. Denied any previous history of regular or even infrequent marijuana use. O/E she seemed moderately anxious but not overly so in that I’d consider sedation. Vitals as follows: HR 130-140 sinus tach, RR 24, BP 230/130, 12-lead unremarkable. Hx of well controlled HTN (systolic normally sits around 120 with meds, 150-160 without). My partner, who was teching that particular call, elected to work her up for CP and treat with nitro. I felt that labetalol might have been a better option, given that it’s used off label for anxiety and that it could work better at both slowing her heart rate and reducing her BP. Plus, it was technically without protocol (we have standing orders to give it for hypertension above 220 systolic). Any experience with this or any arguments for/against it?