Scalp Tingling and Difficulty in Micturition in Patients on Labetalol

1 Labetalol, an alpha‐ and beta‐ adrenoceptor blocking drug, was compared with acebutolol, alone or associated with dihydralazine in forty patients with moderate essential hypertension. 2 Labetalol (400‐ 800 mg daily) seemed to have a slightly higher potency than acebutolol alone (400–800 mg daily). 3 Labetalol (1200–1600 mg daily) had the same potency as the combination of acebutolol (400–800 mg daily) and dihydralazine (50–100 mg daily). 4 Contrarily to acebutolol, the drop in blood pressure with labetalol was not correlated with initial plasma renin activity. 5 Labetalol side effects were minor and did not lead to drug withdrawal.

Section: Discussionsupporting

confidence: 62%

Comparative trial of labetalol and acebutolol, alone or associated with dihydralazine, in treatment of essential hypertension.

Thibonnier¹,

Lardoux²,

Corvol³

1980

“…However, it is interesting to note that most of the patients who were withdrawn from labetalol treatment were on low doses, and some had an appreciable fall in systolic pressure on standing (Table 1). One complained of tingling scalp, an interesting symptom which has been reported previously (Frick & P6rsti, 1976;Hua, Thomas & Kincaid-Smith, 1977;Bailey, 1977). We feel that some subjects may be sensitive to a-adrenoceptor blockade, and that the recommended starting dose of 100 mg 3 times daily, rather than 200 mg twice daily that we used, should help to avert some of these effects.…”

Section: Discussionsupporting

confidence: 58%

Comparison of labetalol and propranolol in hypertension.

Nicholls¹,

Husaini²,

Bulpitt³

et al. 1980

1 Labetalol has been compared with propranolol in a double‐blind, double‐dummy study of 24 patients with mild or moderate essential hypertension. 2 Two patients were unable to tolerate propranolol and five labetalol, because of symptom side effects; this difference was not significant (P greater than 0.1). 3 On a self‐administered questionnaire, labetalol was associated with a greater number of side effects per patient than propranolol, but no individual side effect was significantly more common with either drug. 4 There was no difference in the number of spontaneously reported side effects between the two drugs. 5 Both drugs impaired pulmonary function, but propranolol caused a greater reduction than labetalol after 8 weeks of treatment. 6 We conclude that labetalol and propranolol are similarly effective and acceptable to the patient.

“…In neither the multicentre This has also been reported by Kane, Gregg and Stephens (1981) in their 5 yr study, in which there was a relatively high incidence of side-effects which tended to occur within the first few months. The latter two, formication and difficulty with micturition, are not recognized side-effects of either pure a-or pure ,-blockade, although they have been previously reported with labetalol (Bailey, 1977;Scowen, 1978) and were mentioned by patients on metoprolol in a questionnaire survey (Coulter, 1979).…”

Section: Multicentre Trialmentioning

confidence: 97%

Review of long‐term treatment with labetalol.

Waal‐Manning¹,

Simpson²

1982

1 Labetalol has been used to treat 163 patients at the Dunedin Hypertension Clinic for periods up to 6.5 y, and of 128 patients in a New Zealand multicentre study for 2 yr. 2 Labetalol was often effective when other anti‐hypertensive agents, including beta‐blockers, had failed. It was usually given with a diuretic. 3 Mean daily dose was 700 mg (range 100‐2400 mg). No tolerance to the anti‐hypertensive effect was seen. 4 Some postural‐induced decrease in blood pressure on labetalol was common. 5 Side‐effects led to withdrawal of labetalol in about 25% of patients, mainly during the first few months of therapy. Another 25% had minor side‐effects but could continue with the drug. 6 There were three types of side‐effects (in order of frequency): (a) non‐ specific, (b) related to alpha‐blockade and (c) related to beta‐ blockade. The latter were much less troublesome than on “pure” beta‐ blockers. 7 There was no significant evidence of renal haematological or hepatic toxicity. 8 Anti‐nuclear antibody tests became positive on labetalol in about 15%, usually at low titres but in one patient the titre increased to a high level and fell when labetalol was stopped. 9 In a subset of 25 patients who took labetalol for the longest time (up to 6.5 yr) there was a 16% incidence of anti‐mitochondrial antibodies.