ESMOLOL

Background and Date of Approval

Esmolol is an antiarrhythmic agent approved by the U.S. Food and Drug Administration in 1986 for the treatment of arrhythmia and hypertensive emergencies.

Uses

Esmolol is used to treat various cardiovascular conditions, including high blood pressure (hypertension), and irregular heartbeats known as arrhythmias, and to control heart rate in situations like surgeries or medical procedures.

How is it administered?

Esmolol can be administered only as an intravenous injection into a vein by your physician in a hospital setting. Your physician will decide the correct dosage and duration based on age, body weight, and disease condition.

Side Effects

The side effects known to occur commonly during the treatment with Esmolol are headache, dizziness, excessive sweating, loss of appetite, feeling depressed, confused, or agitated, weakness, sleepiness, irritation and hardening of the skin at the injection site, difficulty concentrating, tingling sensation, nausea, and vomiting.

Warnings

Individuals with kidney problems, including those who require kidney dialysis, are at risk of developing high blood potassium levels (hyperkalemia) when using Esmolol. Hyperkalemia can have serious effects on the heart's function and needs to be monitored and managed carefully. Inform your physician if you have any history of psoriasis (a skin condition characterized by scaly patches) because, during this condition, special consideration is necessary when using this drug. If you are pregnant or planning to become pregnant, you should consult your physician before receiving this drug because the safety of this drug has not been thoroughly studied. Taking this drug during breastfeeding is unsafe because it tends to get excreted in human milk. Consult your doctor for more advice.

Precautions

This drug is contraindicated in individuals with known hypersensitivity or allergy to it or its component. Esmolol should be used cautiously or avoided in individuals with certain conditions, such as severe bradycardia (slow heart rate), heart block, low blood pressure, asthma, and heart failure. Your physician will assess the risks and benefits before prescribing this drug. Regular monitoring of blood pressure and heart rate is important while on treatment with this drug, especially when the dose is adjusted. If you are scheduled for surgery or anesthesia, inform your physician that you are taking this drug, as it can affect your response to anesthesia and other medications.

Word of Advice

Esmolol is utilised for heart rate and blood pressure management. Patients should report any marked changes in heart rate or blood pressure to their doctor promptly. Adequate hydration is important, particularly for patients with renal impairment, as proper fluid intake may help reduce the risk of hyperkalaemia. Patients must not use other medications, including over-the-counter drugs, herbal supplements, or vitamins, without consulting their doctor, as esmolol may interact with other substances.

References

Orpha-Devel Handels und Vertriebs GmbH, Electronic medicines compendium (EMC), [Revised on March 2022] [ Accessed on 17th August 2023], https://www.medicines.org.uk/emc/files/pil.3057.pdf Baxter Healthcare Corporation, US Food and Drug Administration, [Revised on Dec 2012] [ Accessed on 17th August 2023], https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/019386s043lbl.pdf Goodman & Gilman’s, The Pharmacological Basis of Therapeutics, Adrenergic agonists and antagonists, 12th edition, 2011, 327. KD Tripathi, Essentials of Medical Pharmacology, Antihypertensive drugs, 7th edition, 2013, 573.

Frequently Asked Questions

How does Esmolol work?

Esmolol works by blocking the effects of adrenaline and other stress hormones on the heart. This leads to a decrease in heart rate and blood pressure, making it useful in managing rapid heart rhythms and hypertension.

How is Esmolol administered?

Esmolol is usually administered as an intravenous (IV) infusion. This means it's delivered directly into a vein through a controlled infusion pump.

What is the onset of action of Esmolol?

Esmolol has a rapid onset of action, typically within minutes after administration. This quick action is useful in managing acute situations where heart rate control is needed.

What are the common side effects of Esmolol?

Common side effects of Esmolol may include a slow heart rate, low blood pressure, dizziness, fatigue, nausea, and shortness of breath. Serious side effects like allergic reactions, heart block, or worsening heart failure are rare but possible.

Can Esmolol interact with other medications?

Esmolol can interact with other medications, including other heart medications, blood pressure-lowering drugs, and certain anesthetics. It's important to inform your physician about all the medications you're taking to avoid such interactions.

Available Brands 1

Written By: Muskan Patel, M.Pharm

Reviewed By: Dr. Vishwa Patel, MBBS