Labegest 200 mg is a dual-action alpha- and beta-adrenoceptor blocker used to manage various forms of hypertension and related cardiovascular conditions. It effectively lowers blood pressure without causing reflex tachycardia, making it suitable for chronic hypertension, pregnancy-induced hypertension, and situations where rapid or controlled blood pressure reduction is required. Labegest also plays a role in managing angina in hypertensive patients, catecholamine excess, and pheochromocytoma.

রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Therapeutic Class

Alpha- and Beta-Adrenoceptor Blocking Drugs

Indications

Labegest 200 mg is indicated for:

• Hypertension

  • All grades of essential hypertension

  • Pregnancy-induced hypertension

• Cardiovascular Conditions

  • Angina in hypertensive patients

  • Hypertensive episodes during anesthesia

  • Hypertension related to catecholamine excess or pheochromocytoma

Pharmacology

Labegest 200 mg works by competitively blocking β-receptors in the myocardium, bronchial and vascular smooth muscle, and α1-receptors in vascular smooth muscle. This dual blockade reduces blood pressure without reflex tachycardia. Labegest also exhibits mild β2-agonist and membrane-stabilizing activity.

• Alpha-blockade: Attenuates pressor responses to stimuli such as phenylephrine or cold exposure.

• Beta1-blockade: Lowers resting heart rate and blunts exercise-induced tachycardia.

• Beta2-blockade: Inhibits isoproterenol-induced decrease in diastolic blood pressure.

Labetalol reduces cardiac output slightly, decreases total peripheral resistance, and lowers plasma renin activity, contributing to overall antihypertensive effects.

Dosage and Administration

Oral (Adults):

• Initial dose: 100 mg twice daily, alone or with diuretics

• Titration: Increase in 100 mg increments every 2–3 days as needed

• Maintenance: 200–400 mg twice daily

• Severe hypertension: 1,200–2,400 mg per day (split doses or thrice daily for tolerability)

Intravenous (Adults):

• Bolus injection: 50 mg IV over ≥1 minute, repeat every 5 minutes if needed (max 200 mg)

• IV infusion: 1 mg/ml diluted in compatible fluids (5% dextrose, 0.9% saline)

• Pregnancy-induced hypertension: Start at 20 mg/hr, double every 30 minutes up to 160 mg/hr

• Acute myocardial infarction: Start at 15 mg/hr, increase gradually to max 120 mg/hr

Hypotensive anesthesia:

• IV induction: 10–30 mg depending on patient condition

• Incremental doses: 5–10 mg until desired blood pressure achieved

• Halothane concentration: ≤1–1.5% due to synergistic effects

Pediatric Use:

• Safety and efficacy not established

Elderly:

• Initiate at 100 mg twice daily; lower maintenance doses may be sufficient due to slower drug elimination

Drug Interactions

• Synergistic hypotension: With halothane, nitroglycerin

• Bioavailability changes: Increased with cimetidine; decreased with glutethimide

• Other interactions: Tremor with tricyclic antidepressants; bradycardia/heart block with calcium channel blockers (e.g., verapamil, diltiazem)

  রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Contraindications

• Obstructive airway disease (e.g., asthma)

• Second or third-degree heart block

• Cardiogenic shock, severe/prolonged hypotension

• Uncompensated heart failure

• Severe bradycardia

Side Effects

Common and serious side effects may include:

• Postural hypotension, dizziness, lightheadedness

• Fatigue, weakness, headache

• Rash, scalp tingling

• Gastrointestinal symptoms: nausea, vomiting, epigastric pain

• Liver injury in rare cases

• Difficulty in urination

Pregnancy and Lactation

• Pregnancy Category C: Use only if benefits outweigh risks

• Teratogenic studies in animals showed no consistent fetal malformations, though increased fetal resorption was observed at high doses

• Neonates of treated mothers may experience hypotension, bradycardia, hypoglycemia, and respiratory depression

• Small amounts excreted in breast milk; caution advised

Precautions and Warnings

• Patients with pheochromocytoma, DM, non-allergic bronchospasm, or compromised cardiac function

• May mask hypoglycemia symptoms in diabetics

• Avoid abrupt withdrawal to prevent angina exacerbation

• Monitor closely in hepatic impairment, elderly, pregnant, or lactating patients

Storage Conditions

• Store in a cool, dry place, protected from light

• Keep out of reach of children.