Concise Prescribing Info
Esmolol HCl
Rapid control of ventricular rate in patients w/ atrial fibrillation or atrial flutter in peri- & post-op, or other emergent circumstances where short term control of ventricular rate w/ a short-acting agent is desirable. Noncompensatory sinus tachycardia where the rapid heart rate requires specific intervention. Tachycardia & HTN that occur during induction & tracheal intubation during surgery, on emergence from anesth, & in post-op period.
Dosage/Direction for Use
Supraventricular tachycardia Initially 0.5 mg/kg loading dose infused over a min duration followed by maintenance infusion 0.05 mg/kg/min for the next 4 min. May be continued at 0.05 mg/kg/min or increased step-wise w/ each step maintained for ≥4 min. Intra- & post-op tachycardia &/or HTN Immediate control (tachycardia &/or HTN intraop treatment): 80 mg bolus dose over 30 sec followed by 150 mcg/kg/min infusion, if necessary. Adjust the infusion rate as required up to 300 mcg/kg/min to maintain desired heart rate &/or BP. Gradual control (post-op tachycardia & HTN): Initially 500 mcg/kg/min loading dose infusion for 1 min followed by a 4-min maintenance infusion of 50 mcg/kg/min. If adequate therapeutic effect is not observed w/in 5 min, repeat same loading dose & followed by a maintenance infusion increased to 100 mcg/kg/min.
Sinus bradycardia, heart block greater than 1st degree, cardiogenic shock or overt heart failure.
Special Precautions
Renal impairment. Closely monitor patients for risk of hypotension & if pretreatment BP is low. Patients compromised hemodynamically, receiving other drugs that decreases peripheral resistance, myocardial filling & contractility or electrical impulse propagation in the myocardium. Do not use in patients w/ increased BP due to vasoconstriction associated w/ hypothermia as treatment for HTN. Bronchospastic diseases. Diabetics. Pregnancy & lactation. Childn.
Adverse Reactions
Symptomatic (diaphoresis, dizziness) & asymptomatic hypotension, peripheral ischemia. Dizziness, somnolence, confusion, headache, agitation & fatigue. Nausea & vomiting. Inflammation & induration in infusion site.
Drug Interactions
Addictive effect w/ catecholamine-depleting drugs eg, reserpine. Increased blood levels of digoxin. Increased steady-state blood levels w/ morphine. Prolonged duration of neuromuscular blockade. Concomitant use w/ digoxin, morphine, succinylcholine or warfarin. Fatal cardiac arrests may occur w/ verapamil. May block cardiac contractility when systemic vascular resistance is high w/ dopamine, epinephrine & norepinepinephrine.
MIMS Class
ATC Classification
C07AB09 - esmolol ; Belongs to the class of selective beta-blocking agents. Used in the treatment of cardiovascular diseases.
Esbloc inj 100 mg/10 mL
10 × 1's
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