Classes
DEA Class; Rx
Common Brand Names; Brevibloc
- Antidysrhythmics, II;
- Beta-Blockers, Beta-1 Selective
Description
Intravenous beta-blocker
Used for short-term treatment of supraventricular tachycardia, including atrial fibrillation and atrial flutter, noncompensatory sinus tachycardia, and perioperative tachycardia and hypertension
Rapid onset, short duration
Indications
Indicated for the short-term treatment of noncompensatory sinus tachycardia or paroxysmal supraventricular tachycardia (PSVT), including atrial fibrillation and atrial flutter.
Contraindications
Hypersensitivity
Sinus bradycardia, 2°/3° heart block, cardiogenic shock, overt cardiac failure
Asthma/COPD
Sick sinus syndrome without permanent pacemaker
Adverse Effects
- Hypotension, asymptomatic (25-38%)
- Hypotension, symptomatic (12%)
- Injection site pain (8%)
- Nausea (7%)
- Dizziness (3%)
- Somnolence (3%)
- Agitation (2%)
- Confusion(2%)
- Headache (2%)
- Fatigue (1%)
- Vomiting (1%)
- Bradycardia
- Chest pain
- Anxiety
- Anorexia
- Depression
- Abdominal discomfort
- Constipation
- Dry mouth
- Dyspepsia
- Taste perversion
- Bronchospasm
- Dyspnea
- Nasal congestion
- Wheezing
Warnings
Anesthesia/surgery (myocardial depression), bronchospastic disease, cerebrovascular insufficiency, CHF, DM, hyperthyroidism/thyrotoxicosis, liver disease, renal impairment, peripheral vascular disease, myasthenic conditions
Sudden discontinuation can exacerbate angina and lead to myocardial infarction
Increased risk of stroke after surgery
Use in pheochromocytoma
Avoid abrupt withdrawal
Pregnancy and Lactation
Pregnancy Category: C; D in 2nd and 3rd trimesters (expert analysis)
Lactation: excretion in milk unknown; use with caution
Maximum Dosage
500 mcg/kg/dose IV load and 300 mcg/kg/minute continuous IV infusion.
500 mcg/kg/dose IV load and 300 mcg/kg/minute continuous IV infusion.
Safety and efficacy have not been established; however, 1,000 mcg/kg/dose IV load and 1,000 mcg/kg/minute continuous IV infusion have been used.
Safety and efficacy have not been established; however, 1,000 mcg/kg/dose IV load and 1,000 mcg/kg/minute continuous IV infusion have been used.
Safety and efficacy have not been established; however, 1,000 mcg/kg/dose IV load and 1,000 mcg/kg/minute continuous IV infusion have been used.
Safety and efficacy have not been established; however, 500 mcg/kg/dose IV load and 1,000 mcg/kg/minute continuous IV infusion have been used.
How supplied
Esmolol hydrochloride
infusion bags
- 2g/100mL
- 2.5g/250mL
injectable solution
- 10mg/mL
- 20mg/mL
