70
Blood Pressure Management
Table 22. Common Oral Antihypertensive Agents in Pregnancy
Drug Dosage Comments
Labetalol 200–2400 mg/d orally in
two to three divided doses.
Commonly initiated at
100–200 mg twice daily.
Potential bronchoconstrictive
effects.
Avoid in women with asthma,
preexisting myocardial disease,
decompensated cardiac
function, and heart block and
bradycardia.
Nifedipine 30–120 mg/d orally
of an extended-release
preparation. Commonly
initiated at 30–60 mg once
daily (extended release).
Do not use sublingual form.
Immediate-release formulation
should generally be reserved
for control of severe, acutely
elevated blood pressures in
hospitalized patients. Should be
avoided in tachycardia.
Methyldopa 500–3000 mg/d orally in
two to four divided doses.
Commonly initiated at 250
mg twice or three times
daily.
Safety data up to 7 years of age
in offspring.
May not be as effective as other
medications, especially in
control of severe hypertension.
Use limited by side effect profile
(sedation, depression, dizziness).
Hydrochlorothiazide 12.5–50 mg daily Second-line or third-line agent.
Reprinted with permission from American College of Obstetricians and Gynecologists
Copyright © 2019 American College of Obstetricians and Gynecologists.
