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- alpha-1 and non-selective beta blocker
- beta blockade predominates during IV administration (3-7 times alpha blockade)
- beta blockade prevents reflex increase in heart rate, cardiac output and myocardial oxygen consumption
- in pre-eclampsia rapidly reduces BP without decreasing uteroplacental blood flow
- crosses placenta but neonatal bradycardia and hypoglycaemia rarely seen
- disadvantages in pre-eclampsia include interpatient variability in dose requirement and variable duration of action


For acute hypertension

  • bolus of 1-2 mg/kg over 10 min
  • OR mini-boluses of 20 mg followed by 20-80 mg every 10 min
  • OR incremental infusion of 0.5-4 mg /min. This method is least likely to cause hypotension and bradycardia

For pre-eclampsia

  • 10 mg IV initially
  • double dose every 10 min as necessary to a maximum of 300 mg
  • alternatively: 1-2 mg/min IVI reducing to 0.5 mg/min or less after arterial pressure is controlled

© Charles Gomersall December 1999


©Charles Gomersall, April, 2014 unless otherwise stated. The author, editor and The Chinese University of Hong Kong take no responsibility for any adverse event resulting from the use of this webpage.
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