Labetalol concerns

[Anxiousannie8989]

Hello, I was put on labetalol for high blood pressure and pre eclampsia during my 3rd trimester of pregnancy. I’m now 3 months post partum and still on 200mg a day which the dr is t trying to get me off.

My question however is, I have read that labetalol can cause heart failure?! Is this correct because it’s making me quite anxious to keep taking it.

Any advice and support would be great!

Thank you

[Happyrosie]

I haven’t read the pack insert myself Annie but I have two suggestions. The immediate one tomorrow is to speak to your pharmacist. Assuming you’re in the UK this is part of their function, and they can ask you questions about your family and medical history and your lifestyle.The second is to browse through the website of Blood Pressure UK, It probably won’t answer your question but might give you insight.

[Spamt]

Hello. So, I suffered post partum pre eclampsia after having my baby twins - now two - and I totally get why you are anxious. First off, that's absolutely normal - to be honest, I spent six months assuming I was going to have a hideous blood pressure spike and a stroke at any moment. Also, not only was I pretty ill, but about a month after the birth - long before I'd got anywhere near getting off labetalol, one of the boys got desperately ill and ended up on a ventilator. I was so stressed I figured the chances of my blood pressure getting to normal were pretty slim, so I decided to stop worrying about it. Here's what I learned - I hope it helps you:

1. I left hospital on 200mg of labetalol 3 x a day plus 10mg of nifedipine 3 x a day, and I'm now on nothing - so don't panic, it can be done. If you are only on 200mg a day, that's good already - if you're on the same as I was, then don't worry too.

2. They told me at the hospital that I could get off labetalol in 6 weeks - but it actually took me six months. I tried the 'half it every week' method that they suggested, and all that happened was my blood pressure would go high again - quite possibly because I was scared and taking the readings all the time - and I ended up back in hospital.

3. In the end, I bought myself a pill cutter and went down by a quarter every two to four weeks. I got rid of the nifedipine first as that seemed to be the scarier and more potent of the two drugs. I found by only cutting it a very small amount, it wasn't so scary, but it worked in the end. In the end I was literally taking a quarter of a pill for about three weeks before I totally stopped, but it worked. I asked the blood pressure specialist from the hospital if doing it this way was doing me any harm - and was told no, the most harmful thing I could do for my body was to stop taking the drugs.

4. The docs told me most people who have pre eclampsia find their blood pressure will return to normal, some people are unlucky and it stays a bit highter. If this happens - and you really won't know for months, at least six and prob more - then I was told I would be taken off labetalol and put on something more suitable for long term control. My doc was surprised I was on labetalol as it was seen as quite an 'old fashioned' blood pressure drug, but it does seem to be the medicine of choice for pre-eclampsia - maybe it just works best.

5. I did experience something a bit like a fluttering sensation in my chest. I was scared it was my heart, but I was also taking quite serious anti indigestion beta blockers and on reflection, it was more likely to be them as it carried on after the labetalol had finished.

I had never had a health emergency like that before and it really did affect me badly. I found talking to friends who had high blood pressure really helped as they made me see that whatever happened, it was treatable. My blood pressure had been wobbling for a couple of months, but I it was only on the night of the birth that everything went a bit mad, I really thought I wasn't going to see my kids grow up, so I totally hear your fear - but please, try not to worry. One doctor said to me - "You've done it, you've made it - you've got through the scary part, now it's just about giving it time for everything to calm down and it will take a year before your body is back to normal, so don't rush things, give yourself time" - when I thought about it like that, it really helped.

I read the label and info about labetalol causing heart problems like you, but I figured I hadn't had any immediate issues, so that was fine as I'd had a big dose as the emergency dose and it had been fine. Plus, I knew it was a waiting game, but if I had to have blood pressure drugs long term, then it wouldn't be labetalol anyway. But three months isn't a very long time to have it, and either way, you're not going to be on it for life. Maybe slow the process down and check with your doctor about possible side effects. You could change the medicine now, but it will mean you have to go through the whole process of finding a pill and levels that work for you again before you can think about reducing it. You're call really, but either way, my advice would be not to stress about time, just reduce it slowly and get on with enjoying your little one - and if you need it, ask for some counselling. My own and my son's trauma left me with PTSD and it really helped to talk it through. Your health visitor should be able to request it for you. Good luck with it all. xxx

[Spamt in reply to Spamt]

...also, forgot to say - the placenta markers in your blood pushing your blood pressure up stay in your system for at least six weeks post partum. So, there's no way of reducing the dose before the birth, and it's slow progress afterwards for those six weeks while everything goes back to normal in your blood after the birth. So, three months post partum to try and reduce isn't so long in the scheme of things...

[PatientPK]

Hello,

I am on 200 mg labetalol x3 times a day and I am taking 10-20 mg nifedipine a day since my baby’s birth. It’s been 10 months and my bp is not stable (it can go really high 200-120 and very low 70-50) and my nifedipine intake depends on my daily bp reading. I have to measure my bp a lot. And I can’t get the COVID vaccine because of my unstable bp (this is what my gp said). I also read the side effects but this is the medication recommended for breastfeeding mothers. I talked with different doctors, as long as I continue on breastfeeding I don’t have any other alternative. Please talk to your gp and ask your alternatives. It might be different in your case. Hope you get well soon.