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Indication & Dosage |
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| Intravenous |
| RAPID TEMPORARY CONTROL OF VENTRICULAR RATE IN SUPRAVENTRICULAR ARRHYTHMIAS |
| Adult:
As hydrochloride: initial loading dose of 500 mcg/kg over 1 min followed by a maintenance infusion of 50 mcg/kg/min for 4 min. Continue infusion if satisfactory response is achieved, if not, a 2nd loading dose of 500 mcg/kg may be given over 1 min. Maintenance infusion may then be increased to 100 mcg/kg/min for 4 min, further increases can be done in steps of 50 mcg/kg/min up to 200 mcg/kg/min. Once response is satisfactory, infusion may be maintained for up to 48 hr, if necessary. |
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| Intravenous |
| CONTROL OF PERIOPERATIVE HYPERTENSION AND TACHYCARDIA |
| Adult:
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| Precautions |
Hypotension, tachycardia, PVD, uncompensated heart failure, haemodynamically compromised patients, depressed cardiac contractility, DM, bronchospastic disease, renal impairment. Lactation. Children. |
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Potentially Life-threatening
Adverse Drug Reactions |
Hypotension, bradycardia, heart failure, local irritation, diaphoresis, peripheral ischaemia, dizziness, somnolence, confusion, fatigue, paraesthesia, peripheral neuropathy, headache, weakness, irritability, dyspnoea, nausea, vomiting, blurred vision, urinary retention, fever, rigor, muscular pain. |
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| Adverse Drug Reactions |
Profound bradycardia, AV block, cardiogenic shock, asystole, bronchospasm. |
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| Interactions |
Increased risk of bradycardia, AV block, hypotension and CHF with IV calcium channel blockers. Increased hypertensive risk with inotropes, adrenaline or noradrenaline. Hypotension or marked bradycardia with catecholamine depletors. Esmolol HCl may increase blood digoxin levels; it may prolong neuromuscular blockade of succinylcholine. Morphine and warfarin may increase steady-state blood esmolol levels. Bradycardia may occur when used concurrently with MAOIs. Esmolol may reduce elimination of theophylline. |
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