Baxter Healthcare


Baxter Healthcare
Firma Chun Cheong
Concise Prescribing Info
Esmolol HCl
Rapid control of ventricular rate in patients w/ atrial fibrillation or atrial flutter in peri-op, post-op or other emergent circumstances where short-term control of ventricular rate w/ a short-acting agent is desirable. Non-compensatory sinus tachycardia where rapid heart rate requires specific intervention. Treatment of tachycardia & HTN that occur during induction & tracheal intubation, during surgery, emergence from anesth & in the post-op period.
Dosage/Direction for Use
Supraventricular tachycardia Loading dose: 500 mcg/kg over 1 min; Maintenance: 50 mcg/kg/min for 4 min. If response is satisfactory, continue maintenance infusion. If response is unsatisfactory, give 2nd loading dose of 500 mcg/kg, followed by maintenance infusion of 100 mcg/kg/min for 4 min. If needed, procedure may be repeated 1-2 times (up to max of 3 loading doses), maintenance infusion may be increased by 50 mcg/kg/min each time (max: 200 mcg/kg/min). Maintenance infusion may be continued for up to 24 hr. Maintenance titrated to heart rate or other clinical endpoint. Peri-op HTN &/or tachycardia Intra-op: Loading dose: 80 mg (approx 1 mg/kg) bolus over 30 sec followed by 150 mcg/kg/min infusion, may be increased to 300 mcg/kg/min if necessary. Post-op: Loading dose: 500 mcg/kg/min over 1 min followed by 4-min infusion of 50 mcg/kg/min. If effect is not observed w/in 5 min, repeat same loading dose & follow w/ a maintenance infusion increased to 100 mcg/kg/min.
Sinus bradycardia, heart block >1st degree, cardiogenic shock or overt heart failure. Pregnancy (3rd trimester).
Special Precautions
Hypotension, depressed myocardial contractility, hemodynamically compromised patients, intra-operative & post-op tachycardia &/or HTN, bronchospastic diseases, DM & hypoglycemia, renal impairment. Lactation. Childn.
Adverse Reactions
Hypotension, diaphoresis, dizziness, somnolence, confusion, headache, agitation, fatigue, nausea, vomiting. Infusion site reactions eg inflammation & induration.
Drug Interactions
Additive effect w/ catecholamine-depleting drugs. Increases digoxin level. Prolongs neuromuscular-blockade of succinylcholine. Morphine & warfarin may increase steady-state blood esmolol levels. Increased hypertensive risk w/ vasoconstrictors & inotropes eg dopamine, epinephrine & norepinephrine. Incompatible w/ Na bicarbonate.
MIMS Class
ATC Classification
C07AB09 - esmolol ; Belongs to the class of selective beta-blocking agents. Used in the treatment of cardiovascular diseases.
Brevibloc premixed inj 10 mg/mL
250 mL x 1's
Brevibloc inj 10 mg/mL
10 mL x 25 × 1's
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