esmolol hydrochloride at a glance
Medicine class
Short-acting, beta-1-selective beta blocker
How it is given
Intravenously by trained healthcare professionals
Usual setting
Hospital, operating theatre or another closely monitored acute-care setting
Monitoring
Continuous blood pressure, heart rate and ECG monitoring
What is esmolol hydrochloride used for?
The selected UK products are licensed for short-term treatment in adults when rapid control is required.
Supraventricular tachycardia, except tachycardias associated with pre-excitation syndromes
Rapid control of ventricular rate in atrial fibrillation or atrial flutter
Non-compensatory sinus tachycardia requiring specific intervention
Tachycardia and hypertension around anaesthesia, surgery or the postoperative period
How does esmolol hydrochloride work?
It mainly blocks beta-1 receptors in the heart, slowing heart rate and electrical conduction while reducing cardiac contraction and blood pressure. Red-blood-cell esterases break it down rapidly, giving it a short duration of action.
esmolol hydrochloride preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 10 mg/mL, 2500 mg
Injection
Route: Parenteral
Strengths: 10 mg/mL
How to take esmolol hydrochloride
A doctor or nurse administers it into a vein and adjusts treatment according to the clinical response. It is not taken by mouth, so food does not affect administration.
The premixed infusion bag is ready to use and must not have other medicines added.
The vial is single-use; staff inspect the solution and check compatibility before administration.
Treatment should not be stopped abruptly where rebound tachycardia or hypertension is a concern.
esmolol hydrochloride side effects
Common or expected effects
- Low blood pressure, sometimes with dizziness or sweating
- Excessive sweating
- Nausea or vomiting
- Headache, sleepiness, weakness or fatigue
- Injection or infusion-site irritation, inflammation or hardening
Get urgent medical advice
- Marked slowing of the heart or heart block
- Fainting, severe low blood pressure or circulatory collapse
- New or worsening heart failure, chest pain or cardiac arrest
- Breathlessness, wheezing or bronchospasm
- Seizures
- Severe allergic reaction, including facial swelling or hives
- Severe infusion-site injury if solution leaks outside the vein
esmolol hydrochloride in pregnancy
Pregnancy data are limited. It can be used when a doctor considers it necessary, although the product information does not recommend routine use. Later in pregnancy or near delivery, the fetus or newborn may require monitoring for slow heart rate, low blood pressure or low blood glucose.
esmolol hydrochloride while breastfeeding
The selected product information advises against use during breastfeeding because transfer into human milk is unknown and risk to the infant cannot be excluded. Discuss breastfeeding with the treating specialist.
esmolol hydrochloride interactions
Several combinations can increase cardiovascular or metabolic effects.
Intravenous verapamil
The combination can markedly impair heart contraction and conduction; current or recent intravenous verapamil is contraindicated.
Diltiazem and other calcium-channel blockers
May increase low blood pressure, impaired conduction or heart failure.
Amiodarone or class I antiarrhythmics
Effects on cardiac conduction and contraction may increase.
Common questions about esmolol hydrochloride
Answers are fully visible for fast scanning and source review.
Why is esmolol hydrochloride given only in hospital?
It acts quickly and can rapidly lower heart rate and blood pressure, requiring intravenous administration and continuous cardiovascular monitoring.
Is Brevibloc the same as esmolol hydrochloride?
Brevibloc is a brand containing esmolol hydrochloride. The selected Brevibloc product is a premixed infusion bag, while another selected product is supplied in a vial.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.