Experiences of Labetalol for high blood pressure

[UsernamesHarderThanBabyNames]

I'm 37+2 and a few days ago I was prescribed a low dose of Labetalol as my BP has crept up from the top end of normal (which is where it's been my whole life regardless of lifestyle changes etc) to being officially high - peaked at 150/105 during one check last week but generally more like 140/95, so just over the 140/90 threshold they're happy with. I got checked by midwife yesterday (five days after starting drugs) and unfortunately the drop so far only seems to have been marginal. I am seeing a consultant later today and am concerned that he will want to up the dose - the midwife suspects he will, although she also thinks I'll be booked for induction after 38 weeks which is next week. My question is, is there really any point in messing with dosages so late in the pregnancy? Wouldn't the drugs take a few days to kick in anyway or are they supposed to work straight away? I have no other symptoms of pre-eclampsia or anything and have had an otherwise straightforward pregnancy. At this point I'd rather just continue the drugs at the current dose, especially as my BP is only marginally higher than my body and my baby are used to, and get the baby out sooner rather than later, as even at this low dose the drugs are making me feel rubbish and I worry about how they're affecting the baby. What are other people's experience of all this?

[Teeste]

I'm 37 weeks and on 200mg labetalol twice a day after my BP was measuring mid-140s over mid-90s. I also have high BMI, so they're monitoring me extra carefully on full pre-eclampsia watch (no protein in urine yet though). The drugs have helped so far, but I also feel rubbish - a bit like having the flu without the temperature. I'm occasionally shivery, then sweaty, my skin feels all sensitive and I have no energy whatsoever. Is this like your experience? It could also be the amoxicillin I'm on, though. I'll be asking the consultant later today at my appt.

The labetalol did work fairly instantly when they put me on it (back down to the 120/80 range), so yes, I'd say upping the dose could be effective. I also recall the MW saying there are other drugs that can work on BP, can't remember the name of them though. I think you may well have options, but your consultant will be far more knowledgable than I am. I'd talk it over with him and make sure you ask about alternatives. Consultants IME are a bit single-minded and forget to actually offer options.

[UsernamesHarderThanBabyNames]

Thanks teeste, that's interesting. Are you likely to be induced early too do you know? Main side effects seem to be feeling massively tired and sleeping badly (thought this was just a normal late preg thing but midwife said the drugs will be making it worse), but also a crazily itchy scalp - apparently very common but so annoying!

[Number3cometome]

Labetalol works instantly. It is very important to keep your BP under control (take it from someone who had seizures in labour)

I was on Labetalol in my last pregnancy, currently on Methyldopa.

[Teeste]

I don't know about induction, I guess it'll depend on my BP at my appt this afternoon. I don't feel anywhere near ready to give birth, not even had a single Braxton Hicks, and am a bit nervous about inductions as I've heard they're extra painful. But since I now can't have a 'normal' birth and will be medicalised anyway, I may as well make use of all the good painkilling drugs ;)

Itchy scalp must be driving you crazy! Totally get the tiredness thing, it's like the first trimester all over again - in bed by 9.30 most nights now.

At least there are only 5 weeks max to go...healthy baby and healthy mum are the priority at this point, so I'll probably go with what the experts recommend. Everyone keeps telling me I won't remember any of this awfulness post-birth anyway!

[Number3cometome]

I don't think they'll rush to induce you unless it goes up by a lot, 120/80 is well within the recommended range.

Depends how much you are on too, you can up the dose of labetalol a long way before having to try other drugs in combination.

Don't rely on protein to be present, I had none when I had eclampsia and pre-eclampsia. That being said, high BP doesn't mean anything other than high BP either.

[Teeste]

Well, considering my BP was 'only' mild hypertension, I was admitted to the antenatal ward for 2 days for constant monitoring. I think it was because of my BMI and the higher risk I'm at of developing PE, but it all felt a bit overkill tbh. I'm guessing if my BP spikes again, they'll react with similar caution.

All the consultants/doctors said PE always presents with protein in the urine so I believed them

Do they take you off labetalol immediately after birth or do they wean you off it?

[Number3cometome]

That's a complete myth, protein in the urine is not always there, i've always had bloods to confirm - you can find research online about it.
I had full blown seizures and not even a single + of protein.

No, unfortunately, I have been left with permanent high BP, so I take Bisoprolol outside of pregnancy (which I get on fine with)

[JoandMax]

I had labetalol with my first DC, BP suddenly shot up at 37 weeks, I was admitted and despite upping the dose and trying methyldopa (made me feel absolutely terrible!) my BP wouldn't come down so I was induced at 38+5 as starting to show signs of PE. My mother, aunt and grandmother all had sudden high BP/signs of PE with their first babies too.

I stayed on labetolol for about 6 weeks, GP gradually reduced the dose. I've had no issues with BP since or in my second pregnancy

[Teeste]

Hmm, Number3, the research I've found re protein seems to all be from the US - maybe it's not filtered down to the NHS yet? Mind you, they did do several blood tests and only one marker was slightly raised and still within normal range. They said it was in line with higher BP, so maybe they do check bloods for signs of PE too?

I'm going to pack my hospital bag before going to this appt this afternoon, just in case!

[Number3cometome]

Yes they should always do bloods too - I had swelling and high BP a few weeks back, had bloods done in MAC which came back fine.

My consultant has put in my notes that no protein was in my urine previously, so they should be aware, although may not be common knowledge on the NHS.

I have seen one NHS paper which has criteria for PE and protein doesn't have to be in the urine - guess it depends on your hospital!

I have been given conflicting info before, this is a new partner, my consultant said this makes me a higher risk, the midwife says it makes me a lower risk.

I think so little is known about PE that a lot of it is guess work!

[Number3cometome]

Methyldopa certainly takes some getting used to, that's for sure.

I am 32+4 now, and have been on them since finding out I was pregnant so most of the symptoms have gone, but still looking forward to getting back on my bisoprolol!