Trandate: Dual-Action Blood Pressure Control for Lasting Stability
| Product dosage: 100mg | |||
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Synonyms | |||
Trandate (labetalol hydrochloride) is a comprehensive antihypertensive agent uniquely engineered to provide dual alpha- and beta-adrenergic receptor blockade. This mechanism allows for precise modulation of sympathetic nervous system activity, making it a cornerstone therapy in the management of both chronic hypertension and urgent hypertensive episodes. Its balanced pharmacological profile facilitates a controlled reduction in blood pressure without compromising cerebral, renal, or coronary perfusion, positioning it as a versatile option for clinicians seeking efficacy with a favorable hemodynamic response. Suitable for a wide patient demographic, including select populations in pregnancy, it represents a critical tool in achieving and maintaining cardiovascular stability.
Features
- Active pharmaceutical ingredient: Labetalol hydrochloride
- Available in oral tablet formulations (100 mg, 200 mg, 300 mg) and intravenous solution
- Dual non-selective beta-adrenergic and selective alpha-1-adrenergic receptor blockade
- Onset of action: Oral ~2 hours; IV ~5 minutes
- Half-life: approximately 6-8 hours
- Hepatic metabolism via glucuronidation; renal excretion of metabolites
Benefits
- Provides balanced reduction in systolic and diastolic blood pressure through dual receptor blockade
- Maintains cardiac output and organ perfusion, reducing risk of ischemic events
- Suitable for use in hypertensive emergencies due to rapid and titratable IV formulation
- Demonstrates a favorable safety profile in pregnancy-associated hypertension (under specialist supervision)
- Minimizes reflex tachycardia commonly associated with pure vasodilators
- Offers flexible dosing regimens adaptable to individual patient response and comorbidities
Common use
Trandate is indicated for the management of hypertension, both as monotherapy and in combination with other antihypertensive agents. It is particularly valuable in cases where tachycardia accompanies hypertension, as its dual mechanism avoids compensatory heart rate increases. In hospital settings, the intravenous formulation is employed for rapid blood pressure control in hypertensive emergencies, including perioperative hypertension and preeclampsia. Its use extends to long-term maintenance therapy, offering sustained control with twice-daily dosing in many patients.
Dosage and direction
Oral administration: Initiate at 100 mg twice daily, titrating upward every 2-3 days based on therapeutic response. Maintenance doses typically range from 200-400 mg twice daily; maximum recommended dose is 2.4 g daily in divided doses.
Intravenous administration: For hypertensive emergencies, administer 20 mg IV push over 2 minutes. Subsequent doses of 40-80 mg may be given at 10-minute intervals until target pressure achieved, to a maximum cumulative dose of 300 mg. Continuous infusion may be initiated at 2 mg/min, titrated to response.
Always administer with or without food consistently to maintain predictable absorption. Tablets should be swallowed whole; do not crush or chew.
Precautions
Monitor blood pressure and heart rate closely during dose titration. Use caution in patients with hepatic impairment; dose reduction may be necessary. May mask signs of hypoglycemia (e.g., tachycardia) in diabetic patients. Can cause fatigue or dizziness—caution patients about operating machinery until response is known. Abrupt discontinuation should be avoided; taper over 1-2 weeks to prevent rebound hypertension. Not recommended in pheochromocytoma without alpha-blockade initiation first.
Contraindications
Hypersensitivity to labetalol or any component of the formulation. Severe bradycardia (<50 bpm), heart block greater than first degree, cardiogenic shock, decompensated heart failure, or severe bronchial asthma. Avoid in uncontrolled heart failure and sick sinus syndrome without a pacemaker.
Possible side effect
Common (>10%): dizziness, fatigue, nausea.
Less common (1-10%): orthostatic hypotension, dyspepsia, scalp tingling, nasal congestion.
Rare (<1%): bronchospasm, heart failure exacerbation, hepatotoxicity, lupus-like syndrome, Peyronie’s disease.
Most adverse effects are dose-dependent and often diminish with continued therapy or dose adjustment.
Drug interaction
Potentiates hypotensive effects with other antihypertensives, nitrates, and alcohol. Cimetidine may increase labetalol levels. Halothane anesthesia may enhance myocardial depression. Reduces efficacy of beta2-agonists (e.g., albuterol). May prolong hypoglycemic effect of insulin and oral antidiabetics. Calcium channel blockers (especially verapamil) may increase risk of bradycardia and AV block.
Missed dose
If a dose is missed, take it as soon as remembered unless it is nearly time for the next dose. Do not double the dose to make up for a missed one. Maintain regular scheduling to ensure consistent therapeutic coverage.
Overdose
Symptoms may include severe hypotension, bradycardia, bronchospasm, and acute heart failure. Management involves cardiovascular support: place patient in supine position, administer IV fluids. For significant bradycardia, atropine may be indicated. Glucagon has been used to reverse beta-blockade effects. Hemodialysis is not effective due to high protein binding.
Storage
Store at controlled room temperature (20-25°C/68-77°F). Protect from light and moisture. Keep in original container tightly closed. Do not use if tablets appear discolored or show signs of degradation. IV solution should be stored according to manufacturer’s instructions and used within specified stability periods after reconstitution.
Disclaimer
This information is intended for healthcare professionals and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider for personalized recommendations. Dosage and suitability depend on individual patient factors including age, renal/hepatic function, and concomitant conditions.
Reviews
“Trandate remains a go-to agent in our hypertension clinic, particularly for patients with elevated heart rate where pure vasodilators are less ideal. The dual blockade offers a physiologic advantage that many newer agents lack.” – Dr. Eleanor Vance, Cardiologist
“In obstetric emergencies, IV labetalol provides rapid, controllable hypotension without compromising uteroplacental blood flow. It’s a staple in our protocol for severe preeclampsia.” – Dr. Marcus Thorne, Maternal-Fetal Medicine Specialist
“While generally well-tolerated, we monitor for orthostasis in elderly patients during initiation. Its twice-daily dosing supports adherence in long-term management.” – Clinical Pharmacist, Geriatric Care Unit