Treatment of Severe Hypertension in Preeclampsia

The goal is a gradual reduction of blood pressure to a level below 160/105 mm Hg. Sudden and severe hypotension should be avoided.

Hydralazine: 5 mg IV, repeat 5 to 10 mg IV every 20 minutes to maximum cumulative total of 20 mg or until blood pressure is controlled.

Labetalol (Trandate): 20 mg IV, followed by 40 mg, then 80 mg, then 80 mg at 10 minute intervals until the desired response is achieved or a maximum total dose of 220 mg is administered.

Methyldopa (Aldomet) 250 mg BID orally, maximum dose 4 g/day

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