What are the common side effects of labetalol. How can patients manage feeling sleepy, dizzy, or weak while taking labetalol. What serious side effects should prompt immediate medical attention. How does labetalol affect the digestive system.

Understanding Labetalol and Its Impact on the Body

Labetalol is a medication used to treat high blood pressure and belongs to a class of drugs known as beta-blockers. While it’s effective in managing hypertension, it’s important to be aware of potential side effects. Most people experience mild side effects that often improve as the body adjusts to the medication. However, some individuals may encounter more serious reactions that require medical attention.

Common Side Effects of Labetalol: What to Expect

Labetalol can cause several common side effects that affect more than 1 in 100 people. These effects are generally mild and often resolve on their own. Here are some of the most frequently reported side effects:

• Feeling sleepy, dizzy, or weak
• Headaches
• Cold fingers or toes
• Nausea or vomiting
• Diarrhea
• Stomach pain

Is it normal to feel dizzy while taking labetalol. Dizziness is a common side effect, especially when first starting the medication or after increasing the dose. If you experience dizziness, it’s advisable to sit or lie down until the feeling passes. Avoid driving, cycling, or operating machinery if you feel sleepy or dizzy.

Managing Digestive System Side Effects

Labetalol can affect the digestive system, causing nausea, vomiting, diarrhea, and stomach pain. Here are some tips to manage these side effects:

Dealing with Nausea and Vomiting

To alleviate nausea and vomiting:

• Stick to simple, bland meals
• Avoid rich or spicy foods
• Take labetalol after a meal or snack
• Stay hydrated by drinking plenty of fluids
• Take small, frequent sips if vomiting occurs

Can nausea from labetalol be prevented. Taking the medication with food can often help reduce nausea. If symptoms persist, consult your healthcare provider for additional strategies or potential dosage adjustments.

Coping with Diarrhea

If you experience diarrhea while taking labetalol:

• Drink plenty of fluids to prevent dehydration
• Avoid caffeine and alcohol
• Eat small, frequent meals
• Consider a probiotic supplement (after consulting your doctor)

When should you be concerned about diarrhea caused by labetalol. If diarrhea persists for more than a few days or is accompanied by severe abdominal pain or fever, contact your healthcare provider immediately.

Cardiovascular and Respiratory Side Effects

Labetalol can sometimes affect the heart and lungs, leading to potentially serious side effects. These may include:

• Shortness of breath with a worsening cough during exercise
• Swollen ankles or legs
• Irregular heartbeat
• Wheezing or tightness in the chest

Why might labetalol cause respiratory symptoms. As a beta-blocker, labetalol can affect the airways, potentially leading to breathing difficulties in some individuals, particularly those with a history of asthma or other respiratory conditions.

Recognizing Serious Side Effects Requiring Immediate Attention

While rare, some side effects of labetalol require immediate medical attention. Seek immediate medical help if you experience:

• Chest pain (call 999 immediately)
• Yellowing of the eyes or skin (jaundice)
• Pale stools or dark urine
• Unexplained bruising or easy bruising
• Signs of a serious allergic reaction (anaphylaxis)

How quickly can serious side effects develop. Serious side effects can occur at any time during treatment with labetalol, from the first dose to long-term use. It’s crucial to be vigilant and seek medical attention promptly if any concerning symptoms arise.

Labetalol and Allergic Reactions: What to Watch For

In rare cases, labetalol can cause a severe allergic reaction known as anaphylaxis. This is a medical emergency requiring immediate attention. Symptoms of anaphylaxis may include:

• Skin rash (itchy, red, swollen, blistered, or peeling)
• Wheezing
• Tightness in the chest or throat
• Difficulty breathing or talking
• Swelling of the mouth, face, lips, tongue, or throat

How common are allergic reactions to labetalol. Severe allergic reactions to labetalol are rare, but they can be life-threatening. If you experience any signs of an allergic reaction, seek emergency medical care immediately.

Strategies for Managing Common Side Effects

While some side effects of labetalol may be unavoidable, there are strategies to manage them effectively:

Dealing with Headaches

• Rest and stay hydrated
• Limit alcohol consumption
• Use over-the-counter pain relievers as recommended by your pharmacist

How long do labetalol-induced headaches typically last. Headaches often subside after the first week of treatment. If they persist beyond this period or become severe, consult your healthcare provider.

Managing Cold Extremities

• Keep hands and feet warm with appropriate clothing
• Massage and wiggle fingers and toes to improve circulation
• Avoid smoking and caffeine
• Use warm water to improve blood flow

Can lifestyle changes help with cold fingers and toes caused by labetalol. Yes, maintaining an active lifestyle, avoiding tobacco, and keeping extremities warm can help mitigate this side effect.

Long-Term Considerations and Monitoring

While many side effects of labetalol are temporary, long-term use requires ongoing monitoring. Regular check-ups with your healthcare provider are essential to:

• Assess the medication’s effectiveness in controlling blood pressure
• Monitor for potential liver function changes
• Evaluate any persistent side effects
• Adjust dosage if necessary

How often should patients on labetalol have check-ups. The frequency of check-ups can vary depending on individual factors, but typically, patients should have their blood pressure and overall health monitored every 3-6 months or as recommended by their healthcare provider.

Importance of Consistent Medication Use

Despite potential side effects, it’s crucial to continue taking labetalol as prescribed. Abruptly stopping the medication can lead to a rapid increase in blood pressure, potentially causing serious health risks. If side effects are bothersome or persistent, discuss alternatives with your healthcare provider rather than discontinuing the medication on your own.

What should patients do if they miss a dose of labetalol. If you miss a dose, take it as soon as you remember. However, if it’s close to the time for your next dose, skip the missed dose and continue with your regular schedule. Never double up on doses to make up for a missed one.

Interactions with Other Medications and Substances

Labetalol can interact with various medications and substances, potentially altering its effectiveness or increasing the risk of side effects. It’s important to inform your healthcare provider about all medications, supplements, and herbal products you’re taking. Some notable interactions include:

• Other blood pressure medications
• Certain antidepressants
• Some antiarrhythmic drugs
• Drugs used to treat diabetes
• Alcohol

How does alcohol consumption affect patients taking labetalol. Alcohol can enhance the blood pressure-lowering effect of labetalol, potentially leading to excessive drops in blood pressure. It may also intensify side effects like dizziness and drowsiness. It’s advisable to limit alcohol consumption and consult your healthcare provider about safe levels of intake.

Special Considerations for Specific Populations

Certain groups may need special consideration when taking labetalol:

• Pregnant women: Labetalol is often used to treat high blood pressure during pregnancy, but close monitoring is essential.
• Breastfeeding mothers: Small amounts of labetalol can pass into breast milk. Discuss the risks and benefits with your healthcare provider.
• Elderly patients: May be more sensitive to side effects and may require lower doses.
• Patients with diabetes: Labetalol can mask symptoms of low blood sugar.

Are there any specific precautions for diabetic patients taking labetalol. Yes, labetalol can mask symptoms of hypoglycemia, such as rapid heartbeat. Diabetic patients should monitor their blood sugar levels closely and be aware of other signs of low blood sugar, such as sweating, hunger, and confusion.

Alternative Treatments and Lifestyle Modifications

For some patients, the side effects of labetalol may be too challenging to manage. In such cases, healthcare providers may consider alternative treatments or recommend lifestyle modifications to complement or replace medication. These may include:

• Other classes of antihypertensive medications
• Dietary changes, such as reducing sodium intake
• Regular exercise
• Stress management techniques
• Weight loss, if appropriate

Can lifestyle changes alone be sufficient to manage high blood pressure. In some cases, particularly for individuals with mild hypertension, lifestyle modifications can significantly improve blood pressure control. However, this approach should always be undertaken under medical supervision, as many patients require a combination of lifestyle changes and medication for optimal blood pressure management.

The Importance of Patient Education and Communication

Effective management of labetalol side effects relies heavily on patient education and open communication with healthcare providers. Patients should:

• Be informed about potential side effects before starting the medication
• Keep a record of any side effects experienced
• Communicate regularly with their healthcare provider about their experiences
• Ask questions about anything they don’t understand regarding their treatment

How can patients effectively communicate with their healthcare providers about labetalol side effects. Keeping a symptom diary, noting the timing and severity of side effects, can be helpful. Prepare a list of questions before appointments, and don’t hesitate to contact your healthcare provider between visits if you have concerns about side effects or the medication’s effectiveness.

Side effects of labetalol – NHS

Like all medicines, labetalol can cause side effects in some people, but many people have no side effects or only minor ones.

Side effects often improve as your body gets used to the medicine.

Common side effects

These common side effects of labetalol happen in more than 1 in 100 people. They’re usually mild and go away by themselves. There are things you can do to help cope with them:

Feeling sleepy, dizzy or weak

If labetalol makes you feel dizzy or weak, stop what you’re doing and sit or lie down until you feel better. Do not drive, cycle or use tools or machinery if you’re feeling sleepy or dizzy. Do not drink alcohol as it will make you feel worse.

Talk to your doctor if you feel dizzy all the time or this side effect lasts longer than a week.

Headaches

Make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller.

Headaches usually go away after the first week of taking labetalol. Talk to your doctor if the headaches last longer than a week or are severe.

Cold fingers or toes

Put your hands or feet under warm running water, massage them and wiggle your fingers and toes. Do not smoke or have drinks with caffeine in, as this can make your blood vessels narrower and further restrict blood flow to your hands and feet. Try wearing mittens (they’re warmer than gloves) and warm socks. Do not wear tight watches or bracelets.

Feeling sick or being sick (nausea or vomiting)

Stick to simple meals and do not eat rich or spicy food. It might help to take your labetalol after a meal or snack. Drink plenty of fluids, such as water or squash, to avoid dehydration. Take small, frequent sips if you are being sick. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee.

Do not take any other medicines to treat vomiting without speaking to a pharmacist or doctor.

If you take contraceptive pills and you’re being sick, your contraception may not protect you from pregnancy. Check the pill packet to find out what to do.

Diarrhoea

Drink lots of fluids, such as water or squash, to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee.

Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.

If you take contraceptive pills and you have severe diarrhoea for more than 24 hours, your contraception may not protect you from pregnancy. Check the pill packet to find out what to do.

Stomach pain

Try to rest and relax. It can help to eat and drink slowly and have smaller and more frequent meals. Putting a heat pad or covered hot water bottle on your stomach may also help. If you are in a lot of pain, speak to your pharmacist or doctor.

Talk to your doctor or pharmacist if any of these side effects bother you or last more than a few days.

Serious side effects

It does not happen often, but some people have serious side effects when taking labetalol.

Tell a doctor or call 111 now if:

• you have shortness of breath with a cough that gets worse when you exercise (like walking up stairs), swollen ankles or legs, or an irregular heartbeat – these are signs of heart problems
• you have shortness of breath, wheezing and tightening of the chest – these can be signs of lung problems
• the whites of your eyes turn yellow, or your skin turns yellow although this may be less noticeable on brown or black skin, or you have pale poo or dark pee – these can be signs of liver problems
• you get unexplained bruising, or you bruise more easily than usual – these can be signs of low numbers of platelets in your blood (thrombocytopenia)

Immediate action required: Call 999 now if:

• you get chest pain

Chest pain is a possible sign of a heart attack and needs to be checked out as soon as possible.

Serious allergic reaction

In rare cases, labetalol may cause a serious allergic reaction (anaphylaxis).

Immediate action required: Call 999 or go to A&E now if:

• you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
• you’re wheezing
• you get tightness in the chest or throat
• you have trouble breathing or talking
• your mouth, face, lips, tongue or throat start swelling

You could be having a serious allergic reaction and may need immediate treatment in hospital.

Other side effects

These are not all the side effects of labetalol. For a full list, see the leaflet inside your medicine packet.

Information:

You can report any suspected side effect using the Yellow Card safety scheme.

Visit Yellow Card for further information.

Page last reviewed: 7 March 2022

Next review due: 7 March 2025

Labetalol: MedlinePlus Drug Information

pronounced as (la bet’ a lole)

To use the sharing features on this page, please enable JavaScript.

Labetalol is used to treat high blood pressure. Labetalol is in a class of medications called beta blockers. It works by relaxing blood vessels and slowing heart rate to improve blood flow and decrease blood pressure.

High blood pressure is a common condition and when not treated, can cause damage to the brain, heart, blood vessels, kidneys and other parts of the body. Damage to these organs may cause heart disease, a heart attack, heart failure, stroke, kidney failure, loss of vision, and other problems. In addition to taking medication, making lifestyle changes will also help to control your blood pressure. These changes include eating a diet that is low in fat and salt, maintaining a healthy weight, exercising at least 30 minutes most days, not smoking, and using alcohol in moderation.

Labetalol comes as a tablet to take by mouth. It usually is taken two or three times a day. To help you remember to take labetalol, take it around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take labetalol exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Labetalol controls high blood pressure but does not cure it. Continue to take labetalol even if you feel well. Do not stop taking labetalol without talking to your doctor. If you suddenly stop taking labetalol, you may experience serious heart problems such as angina (chest pain) or heart attack.

Labetalol is also used sometimes to treat angina (chest pain) and to treat patients with tetanus. Talk to your doctor about the possible risks of using this medication for your condition.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking labetalol,

• tell your doctor and pharmacist if you are allergic to labetalol, any other medications, or any ingredients in labetalol tablets. Ask your pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: medications for high blood pressure or heart disease; cimetidine; nitroglycerin; and medications for asthma, headaches, allergies, colds, or pain.
• tell your doctor if you have or have ever had heart, kidney, or liver disease; asthma or other lung diseases; severe allergies; diabetes; or pheochromocytoma (a tumor that develops on a gland near the kidneys and may cause high blood pressure and fast heartbeat).
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking labetalol, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking labetalol.
• you should know that this medication may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
• remember that alcohol can add to the drowsiness caused by this medication.

Unless your doctor tells you otherwise, continue your normal diet.

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Labetalol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• dizziness
• tingling scalp or skin
• lightheadedness
• excessive tiredness
• headache
• upset stomach
• stuffy nose

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

• shortness of breath or wheezing
• swelling of the feet and lower legs
• sudden weight gain
• chest pain

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can’t be awakened, immediately call emergency services at 911.

• Normodyne^®¶
• Trandate^®¶

• Normozide^® (containing Labetalol, Hydrochlorothiazide)^¶
• Trandate HCT^® (containing Labetalol, Hydrochlorothiazide)^¶

^¶ This branded product is no longer on the market. Generic alternatives may be available.

Last Revised – 01/15/2018

Browse Drugs and Medicines

Labetalol – instructions for use

Labetalol

Instruction:

• Pharmacological action
• Readings
• Contraindications
• With care
• Pregnancy and breastfeeding
• Dosage and Administration
• Side effects
• Special instructions
• Classification

Pharmacological action

Labetalol is a β-adrenergic blocker, it simultaneously has α ₁ -adrenergic blocking effect.

The combination of β-adrenergic blocking and peripheral vasodilatory action provides a reliable antihypertensive effect. The drug does not significantly affect the amount of cardiac output and heart rate.

Labetalol is used to lower blood pressure in various degrees of hypertension. Unlike conventional β-blockers, it has a rapid antihypertensive effect.

Labetalol is rapidly absorbed when taken orally. The plasma half-life is approximately 4 hours. It is excreted from the body mainly in the urine in the form of inactive metabolites.

Indications

Adults: arterial hypertension, hypertensive crisis.

Children: an experimental treatment for arterial hypertension.

Contraindications

Hypersensitivity to labetalol.

Labetalol is contraindicated in patients with severe heart failure, atrioventricular blockade, although in recent years there have been data on the beneficial effect of intravenous administration of labetalol on systemic, intracardiac and regional hemodynamics in patients in the early stages of myocardial infarction.

Precautions

Bronchial asthma.

Pregnancy and lactation

FDA fetal category C.

Labetalol crosses the placental barrier.

Dosage and Administration

Children

By mouth: Initial dose 3-4 mg/kg/day in 2 divided doses, maximum dose 40 mg/kg/day.

IV: 0.3–1 mg/kg bolus, for hypertensive crises infusion 0.4–1 mg/kg/h, maximum dose 3 mg/kg/h.

Adults

By mouth: Initial dose 100 mg twice daily, increased by 100 mg daily if necessary, at intervals of 2 to 3 days. A dose of 200-400 mg 2 times a day is usually effective. The maximum dose is 2.4 g / day.

IV bolus: 20 mg or 200 mcg/kg over 2 minutes; if necessary, 40–80 mg is administered every 10 minutes; maximum dose 300 mg.

Intravenous infusion: initial dose of 2 mg/min, gradually increasing if necessary.

Side effects

Headache, nausea, constipation or diarrhea, feeling tired, itchy skin.

Special instructions

Intravenous administration is carried out in a hospital in the “lying” position (due to the rapid and significant decrease in blood pressure).

Classification

• ATX

  C07AG01

• Pharmacological group

  Alpha and beta blockers

• FDA pregnancy category

  C
  (risk not excluded)

Share this page

More on the topic

Find out more about the active ingredient Labetalol:

• INN
• Reviews
• Questions (1)
• Latin name
• Chemical formula

Information about the active substance Labetalol is intended for medical and pharmaceutical professionals, for reference purposes only. The instructions are not intended to replace professional medical advice, diagnosis or treatment. The information contained here may change over time. The most accurate information on the use of drugs containing the active substance Labetalol is contained in the manufacturer’s instructions attached to the package.

Labetalol: generic, uses, side effects, dosage, interactions, warnings

Medicines and vitamins

• Brand Name: N/A
• Drug class: N/A

• Medical and pharmaceutical editor: Sarfaroy Khan, BHMS, PGD Health Operations

• Usage
  • What is labetalol and how does it work?
• Side effects
  • What side effects are associated with the use of labetalol?
• Dosages
  • What are the dosages of labetalol?
• Drug Interactions
  • What other drugs interact with labetalol?
• Warnings and Precautions
  • What are the warnings and precautions for labetalol?

What is labetalol and how does it work?

labetalol is a prescription medicine used to treat the symptoms of Hypertension (high blood pressure) as well as Hypertension Emergency.

which tablet contains 3605

• Labetalol is available under the following brand names: Deal

What side effects are associated with the use of labetalol?

Common side effects of labetalol include:

• dizziness,
• drowsiness,
• fatigue,
• nausea,
• vomiting,
• sudden heat,
• reddening of the skin,
• sweating,
• numbness and
• tingling in the scalp

Serious side effects of labetalol include:

• hives,
• shortness of breath,
• swelling of the face, lips, tongue or throat,
• severe dizziness,
• dizziness,
• slow heart rate,
• weak pulse,
• fainting,
• slow breathing or breathing that may stop,
• shortness of breath (even with mild exertion),
• swelling,
• rapid weight gain,
• severe headache,
• blurred vision,
• knocking in the neck or ears,
• loss of appetite,
• stomach pain (upper right side),
• flu-like symptoms,
• itching,
• dark urine and
• yellowing of the skin or eyes (jaundice)

Rare side effects of labetalol include:

• none

This is not a complete list of side effects and other serious side effects or health problems may result from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You can report side effects or health concerns to the FDA at 1-800-FDA-1088.

What are the dosages of labetalol?

Adult and pediatric dosage

Injection solution

• 5 mg/ml

tablet

where to buy ivermectin for human

• 100mg
• 200mg
• 300mg

Hypertension

Adult

• 100 mg orally every 12 hours initially; increase by 100 mg every 12 hours every 2-3 days
• Usual dose range: 200-400 mg orally every 12 hours; no more than 2400 mg / day.

Hypertension emergency

Can Tylenol be taken with Cephalexin?

Adult

• 20 mg IV over 2 minutes initially, then 40-80 mg IV every 10 minutes; the total dose should not exceed 300 mg
• Alternative: 1-2 mg/min by continuous intravenous infusion; a total dose of 300 mg has been used

Pediatric

• 0. 4-1 mg/kg/hour by continuous intravenous infusion; not more than 3 mg/kg/h

Dosage considerations – should be given as follows:

• See “Dosages”.

What other drugs interact with labetalol?

If your doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any potential drug interactions and can monitor them. Do not start, stop, or change the dosage of any medicine without talking to your doctor, health care provider, or pharmacist.

• Labetalol has serious interactions with the following drugs:
  • iobenguane I 123
• Labetalol has serious interactions with at least 19 other drugs.
• Labetalol interacts moderately with at least 168 other drugs.
• Labetalol has minor interactions with at least 32 other drugs.

This information does not contain all possible interactions or side effects. Visit the RxList Drug Interaction Checker to learn about any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Consult with your physician or healthcare professional for further medical advice, or if you have health questions, concerns.

What are the warnings and precautions for labetalol?

Contraindications

woke up with swollen tongue

• Hypersensitivity
• Asthma or obstructive airway disease, severe bradycardia, 2º/3º heart block (without pacemaker), cardiogenic shock, bronchial asthma, uncompensated heart failure, hypersensitivity, sinus bradycardia, sick sinus syndrome without permanent pacemaker; conditions associated with prolonged and severe hypotension.

Consequences of drug abuse

• Nobody

Short-term effects

• See “What side effects are associated with the use of labetalol?”

Long-term effects

• See “What side effects are associated with the use of labetalol?”

Cautions

• Use with caution in anesthesia or surgery (myocardial depression), bronchospastic disease (not recommended), cerebrovascular insufficiency, diabetes diabetes hyperthyroidism or thyrotoxicosis, liver failure, renal failure, peripheral vascular disease, compromised left biliary subsidiary function, advanced age, heart failure, pheochromocytoma
• Increased risk of stroke after surgery
• Serious liver injury reported with use; with long-term use monitor liver function tests
• Sudden cessation may exacerbate angina pectoris and lead to myocardial infarction
• Use with caution in patients taking calcium channel blockers, cardiac glycosides or inhalational anesthetics
• Intraoperative flexible iris syndrome observed during cataract surgery in some patients treated with alpha1 blockers (labetalol is both an alpha and a beta blocker)
• Hypotension with or without syncope may occur; monitor
• Consider pre-existing conditions such as sinus syndrome disease before initiating therapy
• Use caution in patients with severe anaphylaxis to allergens; patients taking beta-blockers may become more sensitive to repeated tests; treatment with epinephrine in patients taking beta-blockers may be ineffective or cause unwanted effects
• Use with caution in patients with myasthenia gravis, psoriasis, or mental illness (may cause or exacerbate CNS depression)

Pregnancy and lactation

• Use with caution if benefits outweigh risks.