Esmolol: functions, dosage, side effects, how to use

What Medicine Esmolol?

What is esmolol for?

Esmolol is a beta 1-selective (cardioselective) adrenergic receptor blocking agent.

Esmolol is generally used to rapidly control the ventricular rate.

Esmolol can also be used for other uses not mentioned in the medical instructions.

How do you use esmolol?

Esmolol should be administered by a health care provider in a clinical setting, where vital signs (blood pressure, heart rate) can be continuously monitored and emergency situations can be managed promptly.

How is esmolol stored?

This medication is best stored at room temperature, away from direct light and damp places. Don't keep it in the bathroom. Don't freeze it. Other brands of this drug may have different storage rules. Observe the storage instructions on the product package or ask your pharmacist. Keep all medicines away from children and pets.

Do not flush medicines down the toilet or down the drain unless instructed to do so. Discard this product when it has expired or when it is no longer needed. Consult your pharmacist or local waste disposal company about how to safely dispose of your product.

Rules of Use Esmolol

The information provided is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist before starting treatment.

What is the dose of esmolol for adults?

Typical adult dosage for Atrial Fibrillation:

Initial dose: Loading infusion of 500 mcg / kg / minute (0.5 mg / kg / minute) for 1 minute.
Maintenance dose: 50 mcg / kg / min (0.05 mg / kg / min) for 4 minutes.

Typical adult dosage for Atrial Flutter:

Initial dose: Loading infusion of 500 mcg / kg / minute (0.5 mg / kg / minute) for 1 minute.
Maintenance dose: 50 mcg / kg / min (0.05 mg / kg / min) for 4 minutes.

The usual adult dosage for supraventricular tachycardia:

Initial dose: Loading infusion of 500 mcg / kg / minute (0.5 mg / kg / minute) for 1 minute.
Maintenance dose: 50 mcg / kg / min (0.05 mg / kg / min) for 4 minutes.

Usual adult dosage for Intra- or Post-op SVT or Hypertension:

Direct control: 80 mg (approx. 1 mg / kg) bolus dose for 30 seconds followed by 150 mcg / kg / min infusion, if needed. Set the infusion rate as needed with a maximum of 300 mcg / kg / minute to maintain heart rate and / or blood pressure.

What is the dose of esmolol for children?

Common pediatric dosage for hypertension:

1 year and over: 100 to 500 mcg / kg given for 1 minute, followed by infusion for control of supraventricular tachycardia (SVT).
A dose of 500 mcg / kg / minute for 1 minute followed by an infusion of 50 - 250 mcg / kg / minute is used as an adjunct to nitroprusside to treat postoperative hypertension after coarctation of aorta repair.

Common pediatric dosage for supraventricular tachycardia:

In what dosage is esmolol available?

Esmolol is available in the following dosages.

Solution, intravenous, hydrochloride: 10 mg / mL (10 mL), 2000 mg (100 mL), 2500 mg (250 mL)
Solution, intravenous, hydrochloride: 10 mg / mL (10 mL), 100 mg / 10 mL (10 mL)

Esmolol dosage

What side effects can be experienced due to esmolol?

Use of Esmolol has often been associated with low blood pressure and other serious side effects. Not everyone experiences the following side effects. There may be some side effects not listed above. If you have concerns about certain side effects, consult your doctor or pharmacist.

Esmolol side effects

What should be known before using esmolol?

Esmolol is contraindicated in patients with:

sinus bradycardia
heart block higher than first degree
sick sinus syndrome
acute heart failure
cardiogenic shock
IV administration of cardiodepressant calcium-channel antagonists (verapamil) and adjacent ESMOLOL
hypertension in the lungs
hypersensitivity reactions, including anaphylaxis to esmolol or the inactive composition of the product (cross-sensitivity among beta blockers is possible).

Is esmolol safe for pregnant and lactating women?

There are no adequate studies regarding the risks of using this drug in pregnant or breastfeeding women. Always consult your doctor to weigh the potential benefits and risks before using this medication. This drug is included in the risk of pregnancy category C according to the US Food and Drug Administration (FDA).

The following references the pregnancy risk categories according to the FDA:

A = No risk,
B = not at risk in several studies,
C = May be risky,
D = There is positive evidence of risk,
X = Contraindicated,
N = Unknown

Esmolol Drug Warnings and Cautions

What medicines may interact with esmolol?

Drug interactions can change the performance of your medications or increase the risk of serious side effects. Not all possible drug interactions are listed in this document. Keep a list of all the products you use (including prescription / non-prescription drugs and herbal products) and consult your doctor or pharmacist. Do not start, stop, or change the dose of any medication without your doctor's approval.

Concomitant use of Esmolol with other medicines can lower blood pressure, reduce myocardinal contractility, or interfere with sinus node function or the propagation of electrical impulses in the myocardium may overestimate the effects of Esmolol on blood pressure, contractility and impulse propagation. Severe interactions with certain drugs can cause, for example, hypotension, heart failure, bradycardia, sinus pause, sinoartial blocks, atrioventricular blocks, and / or cardiac arrest. In addition, with some drugs, beta blockades can trigger an increase in withdrawal effects. (See clonidine, guanfacine, and moxonidine below.)

Esmolol should only be used after an individualized assessment of risk and benefit in patients receiving drugs that may cause pharmacodynamic interactions, including but not limited to:

Digitalis glycosides: Giving digoxin and Esmolol simultaneously results in an increase in digoxin levels in the blood by about 10% - 20%. Digoxin does not affect Esmolol pharmacokinetics. Digoxin and beta blockers slow atrioventricular conduction and decrease heart rate. Concomitant use increases the risk of bradycardia.

Anticholinesterases: Esmolol prolongs the duration of succinylcholine-induced neuromuscular blockade and the clinical duration and healing index of mivacurium.

The antihypertensive agents clonidine, guanfacine, or moxonidine: Beta blockers can also increase the risk of clondidine-, guanfacine-, or moxonidine-withdrawal rebound hypertension. If during concomitant use with beta blockers, antihypertensive therapy needs to be stopped, stop beta blockers first, and discontinue should be gradual.

Calcium channel antagonists: In patients with depressed myocardial infarction, use of Esmolol with cardiodepressant calcium channel antagonists (verapamil) can cause fatal heart attacks.

Sympathomimetic drugs: Sympathomimetic drugs with beta-adrenergic agonist activity will counteract the effects of Esmolol.

Vasoconstrictive and positive inotropic agents:

Because of the risk of reduced cardiac contractility with high vascular system resistance, do not use Esmolol to control tachycardia in patients taking vasoconstrictive drugs that have positive inotropic effects, such as epinephrine, norepinephrine, and dopamine.

Can food or alcohol interact with esmolol?

Certain drugs should not be used with meals or when eating certain foods because drug interactions can occur. Consuming alcohol or tobacco with certain drugs can also cause interactions to occur. Discuss your use of drugs with food, alcohol, or tobacco with your health care provider.

What health conditions can interact with esmolol?

Any other health conditions you have can affect the use of this drug. Always tell your doctor if you have other health problems, especially:

bradycardia (slow heart rate)
heart block
heart failure — should not be used in patients with these conditions.
diabetes
hypoglycemia (low blood sugar) —may include symptoms of this disease, such as a racing heart.
hypotension (low blood pressure) - may make the condition worse.
kidney disease - use with caution. The effect can increase due to prolonged disposal from the body.
lung disease (asthma, bronchitis, emphysema) —may cause

Esmolol Drug Interactions

What should I do in an emergency or overdose?

In case of an emergency or overdose, contact the local emergency services provider (112) or immediately to the nearest hospital emergency department.

Esmolol overdose can cause effects on the heart and central nervous system. These effects can trigger severe signs, symptoms, sequelae and complications (heart and respiratory failure, including shock and coma), and can be fatal. Continuous patient monitoring is required.

What should I do if I miss a dose?

If you forget a dose of this medicine, take it as soon as possible. However, when it is nearing the time of the next dose, skip the missed dose and return to the usual dosing schedule. Don't double the dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.