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General Information on Esmolol

Generic Name : Esmolol

Pronunciation : ES-moe-lol

Latest prescription information about Esmolol. Learn how to pronounce the drug's name, its indications, dosage, how to take, when to take, when not to take, side effects, special precautions, its storage instructions and warnings if any when taken during pregnancy. Also listed are the International and Indian trade name(s) of the drug and its price list.
ICD Code : Y51.7 | Therapeutic Classification : Anti- Hypertensives

Trade Names/Brand Names of Esmolol

India : 

International : 

Brevibloc

Other Name(s) of Esmolol

Esmolol hydrochloride

Overview of Esmolol

Esmolol comes in an injectable form and is used to treat arrhythmia and hypertension in emergency conditions.

Why is Esmolol Prescribed? (Indications)

Esmolol blocks beta-1 receptors, which are present on the heart. This prevents the action of nerve chemicals adrenaline and noradrenaline on the heart. As a result, heart beats at a slower rate and with lesser force, and thus pumps out lesser blood into blood vessels. This action of esmolol reduces blood pressure in the hypertensive patients. Since esmolol slows heart rate, it treats tachycardia (fast heart rate), and irregular heart rate and rhythm (arrhythmia).  

When should Esmolol not to be taken? (Contraindications)

Esmolol should not be given in conditions where the heart is beating slow or with less force. These include:
• Severe sinus bradycardia (extremely low heart rate)
• Second or third-degree atrioventricular block (heart block)
• Sick sinus syndrome
• Decompensated heart failure
• Cardiogenic shock
Other conditions where esmolol should not be used include:
• Pulmonary hypertension
• Known allergy to the drug

What is the dosage of Esmolol?

Intravenous drug dosage for esmolol varies as per the medical conditions.
• For atrial flutter / atrial fibrillation / supraventricular tachycardia: Initial loading dose is 0.5mg/kg/min infused over one minute. Maintenance dose is 0.05 mg/kg/min for 4 minutes. If the response is unsatisfactory within the 1st 5 minutes, give 2nd loading dose of 500 mcg/kg, then maintenance infusion at 100 mcg/kg/min for 4 minutes.
• For intra or post-operative supraventricular tachycardia (SVT) or hypertension: Loading dose is 80 mg, then 150 mcg/kg/min is given via infusion, up to 300 mcg/kg/min if needed. Alternatively, the above regimen may also be used to obtain gradual control.

Missed a Dose?

A patient must never administer esmolol injection by himself.

How should Esmolol be taken?

Esmolol is available in solution in a vial or an ampoule which is injected by the physician in to a vein, in a clinical setting where vital signs can be monitored and emergency conditions can be treated immediately.

What are the warnings and precautions for Esmolol?

• Esmolol interacts with many medications. Make sure that your doctor is informed about your ongoing medications/ supplements, herbal preparations before it is administered.
• Esmolol can mask the symptoms of low blood sugar levels in diabetic patients.

What are the side effects of Esmolol?

• Heart- Low heart rate and blood pressure
• Central Nervous System- Dizziness, drowsiness, confusion, headache, agitation, fatigue
• Respiratory- Wheezing, difficulty in breathing, nasal congestion
• Gastrointestinal- Nausea, vomiting, indigestion, constipation, dry mouth and abdominal discomfort
• Local - Pain and inflammation at the site of injection

What are the other precautions for Esmolol?

Esmolol should be administered with extreme precaution, if the patient suffers from one of the following conditions:
• Diabetes, since it may mask the effects of low blood sugar levels
• Low blood sugar
• Low blood pressure
• Kidney function problems, since the drug is eliminated from the body in the urine
• Respiratory problems like asthma, bronchitis, and emphysema
• Pheochromocytoma, which is a tumor of the adrenal glands that secretes large amounts of adrenaline
• Prinzmetal’s angina, where angina occurs due to spasm of a coronary artery
• Metabolic acidosis
• Hyperthyroidism, or high thyroid hormone levels
• Poor circulation
• Hypovolemic patient, where the blood volume is low

What are the Drug Interactions of Esmolol?

Esmolol should be avoided with:
• Other beta blockers due to additive effects.
• Other drugs that can slow down the heart like verapamil, digitalis, amiodarone and diltiazem.
• Drugs used in the treatment of asthma due to opposite effects on the bronchi
• Antidiabetes medications since esmolol can block the signs of hypoglycemia
• Drugs that act on alpha receptors. Along with alpha agonists like ephedrine, it can produce excessive rise in blood pressure, while with alpha blockers like prazosin, it can result in excess fall in blood pressure
• NSAIDs like ibuprofen and naproxen, which may block the effect of esmolol on blood pressure.
• Anticholinesterase drugs used in Alzheimer's disease like rivastigmine due to additive effect on the heart and blood pressure
• Drugs that lower blood pressure and increase potassium levels like chlorthiazide
• Other drugs that may lower blood pressure like antihypertensive medications, aldesleukin, and barbiturates.

What are the storage conditions for Esmolol?

Store at room temp; protect from elevated temp. Keep away from children.

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