Esmolol Hydrochloride

Esmolol Hydrochloride is a beta adrenergic blocker indicated for the short-term treatment of control of ventricular rate in supraventricular tachycardia including atrial fibrillation and atrial flutter, control of heart rate in noncompensatory sinus tachycardia, and control of perioperative tachycardia and hypertension.

Esmolol Hydrochloride is a beta-1 selective (cardioselective) adrenergic receptor blocking agent with rapid onset, a very short duration of action, and no significant intrinsic sympathomimetic or membrane stabilizing activity at therapeutic dosages. Its elimination half-life after intravenous infusion is approximately 9 minutes.

• Supraventricular Tachycardia: Control of ventricular rate in SVT including atrial fibrillation and atrial flutter.
• Noncompensatory Sinus Tachycardia: Control of heart rate.
• Perioperative Tachycardia and Hypertension: Control of heart rate and blood pressure during and after surgery.

Anti adrenergic agent (Beta blockers)

Beta-1 Selective Adrenergic Blocker

Esmolol Hydrochloride is a beta-1 selective (cardioselective) adrenergic receptor blocking agent with rapid onset, a very short duration of action, and no significant intrinsic sympathomimetic or membrane stabilizing activity at therapeutic dosages. Its elimination half-life after intravenous infusion is approximately 9 minutes. It inhibits the beta 1 receptors located chiefly in cardiac muscle, but at higher doses it begins to inhibit beta 2 receptors located chiefly in the bronchial and vascular musculature.

Esmolol Hydrochloride is a beta-1 selective (cardioselective) adrenergic receptor blocker. It inhibits beta 1 receptors located chiefly in cardiac muscle, reducing heart rate and blood pressure.

Adult Dose (IV):

• SVT or Noncompensatory Sinus Tachycardia: Optional loading dose: 500 mcg/kg over 1 minute, then 50 mcg/kg/min for 4 minutes; adjust as needed up to 200 mcg/kg/min.
• Perioperative Tachycardia and Hypertension: Loading dose: 500 mcg/kg over 1 minute (gradual) or 1 mg/kg over 30 seconds (immediate); then 50 mcg/kg/min (gradual) or 150 mcg/kg/min (immediate); adjust up to 200 (tachycardia) or 300 (hypertension) mcg/kg/min.

Administer intravenously. Titrate using ventricular rate or blood pressure at ≥4 minute intervals.

If you miss a dose of Esmolol Hydrochloride, please consult your doctor.

Common Side Effects (>10%):

• Symptomatic hypotension (hyperhidrosis, dizziness)
• Asymptomatic hypotension

Other Side Effects:

• Nausea
• Infusion site reactions

Precautions:

• Risk of hypotension, bradycardia, and cardiac failure: Reduce or discontinue use.
• Risk of exacerbating reactive airway disease.
• Diabetes mellitus: Increases the effect of hypoglycemic agents and masks hypoglycemic tachycardia.
• Risk of unopposed alpha-agonism and severe hypertension in untreated pheochromocytoma.
• Risk of myocardial ischemia when abruptly discontinued in patients with coronary artery disease.

Contraindications:

• Severe sinus bradycardia
• Heart block greater than first degree
• Sick sinus syndrome
• Decompensated heart failure
• Cardiogenic shock
• Coadministration of IV cardiodepressant calcium-channel antagonists (e.g. verapamil)
• Pulmonary hypertension
• Known hypersensitivity to esmolol

Drug Interactions:

• Digitalis glycosides: Risk of bradycardia
• Anticholinesterases: Prolongs neuromuscular blockade
• Antihypertensive agents: Risk of rebound hypertension
• Sympathomimetic drugs: Dose adjustment needed
• Vasoconstrictive and positive inotropic effect substances: Avoid concomitant use

Food Interactions: It is not known whether it is safe to consume alcohol with Esmolol Hydrochloride. Consult your doctor.

Use in Pregnancy: Category C. Animal studies have shown fetal harm. No adequate studies in pregnant women. Should be used only if potential benefit justifies potential risk to the fetus.

Use in Lactation: It is not known whether Esmolol Hydrochloride is excreted in human milk. A decision should be made whether to discontinue nursing or to discontinue the drug, considering the importance of the drug to the mother.

Pediatric Use: Safety and effectiveness in pediatric patients have not been established.

Geriatric Use: Clinical studies did not include sufficient numbers of subjects aged 65 and over.

Renal Impairment: No dosage adjustment required for renal impairment (for maintenance infusion of 150 mcg/kg).

Hepatic Impairment: No special precautions necessary (metabolized by red-blood cell esterases).

Overdose: Overdose may cause severe hypotension, bradycardia, cardiac failure. In case of overdose, discontinue drug and provide supportive treatment.

Storage: Keep below 25°C, away from light & moisture. Keep out of reach of children.

Esmolol Hydrochloride