Table 1
Type, dosage, and timing of pharmacologic antihypertensive therapies during pregnancy. PO: by mouth; IV: intravenous; BP: blood pressure; BID: twice daily; q: every
| MEDICATION | ROUTE | DOSAGE | MAXIMUM DOSAGE | TIMING OF THERAPY |
|---|---|---|---|---|
| Aspirin | PO | 81 mg | N/A | Begin at 12-16 weeks of gestation and continue until delivery |
| Magnesium sulfate* | IV | Loading dose: 4-6 g bolus Maintenance dose: 2 g/hr if creatinine (Cr) ≤ 1.1; 1 g/hr if Cr > 1.1 | N/A | When patient meets criteria for pre-eclampsia with severe features and continued 24 hours postpartum |
| Hydralazine | IV | 5 or 10 mg, repeat q20 minutes if BP > 160/110. If still elevated, administer alternate medication | 20 mg/day | For acute management until BP controlled |
| Labetalol | IV | Sequence: 20 mg, 40 mg, 80 mg q10 minutes if BP > 160/110 | 300 mg/day | For acute management until BP controlled |
| PO | Begin with 200 mg BID and up-titrate as needed | 2400 mg/day | Titrate to management of normotensive to mild range BP. Re-evaluate 1 week postpartum | |
| Nifedipine immediate release (IR) | PO | 10 mg | 180 mg/day | For acute management of BP |
| Nifedipine extended release (XL) | PO | 30 mg q daily and up-titrate as needed to 60 mg BID | 120 mg/day | Titrate to management of normotensive to mild range BP. Re-evaluate 1 week postpartum |
[i] * For seizure prophylaxis