Table.

Treatment of Acute Severe Hypertension in Preeclampsia

Hydralazine	5 mg IV bolus, then 10 mg every 20 to 30 min to a maximum of 25 mg; repeat in several hours as necessary
Labetalol (second‐line)	20 mg IV bolus, then 40 mg 10 min later; 80 mg every 10 min for 2 additional doses to a maximum of 220 mg
	10 mg PO; repeat every 20 min to a maximum of 30 mg
Nifedipine (controversial)	Use caution when using nifedipine with magnesium sulfate; it can be associated with precipitous BP drops
	Short‐acting nifedipine is not approved by the US Food and Drug Administration for management of hypertension
Sodium nitroprusside (rarely and when others fail)	0.25 mg/kg/min to a maximum of 5 mg/kg/min
	Fetal cyanide poisoning may occur if used for more than 4 hours
Abbreviations: BP, blood pressure; IV, intravenous; PO, by mouth.