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Esmolol: An Intravenous Cardioselective Beta-1 Adrenergic Antagonist

Esmolol is a cardioselective beta-adrenergic blocker, authorized for the rapid control of ventricular rate in patients with atrial fibrillation or atrial flutter in perioperative, postoperative, or other emergent scenarios where short term controlling of ventricular rate with a short-acting agent is required/desirable. The esmolol hydrochloride is also prescribed in non compensatory sinus tachycardia where, in the health specialist's judgement, the rapid heart rate needs specific intervention. This medicinal product is not intended for use in chronic settings where transfer to another agent is anticipated or for treatment periods greater than 24 hours duration.


What Esmolol Does?


Esmolol is classified as beta-adrenergic receptor blocking agents which inhibits the mechanisms of the involuntary nervous system which affects the heart. This medicinal product is quick-acting and has a short duration of action.


Dosage for Supraventricular Tachycardia


In the treatment of supraventricular tachycardia, responses to esmolol typically (over 95%) occur within the range of 50-200 microgram/kg per min (0.05 to 0.2 mg/kg per min). The average effective dosage is around 100 microgram/kg per min (0.1 mg/kg per min) although dosages as low as 25 microgram/kg per min (0.025 mg/kg per min) have been adequate in a few patients. Dosages as high as 300 microgram/kg per min (0.3 mg/kg per min) have been considered, but these provide little added effect and a boosted rate of side effects, and are not recommended. Esmolol dosage in supraventricular tachycardia must be individualised by titration in which each step consists of a loading dose followed by a maintenance dosage.


In order to initiate treatment with esmolol injection for supraventricular tachycardia, administer a loading infusion of 500 microgram/kg per min (0.5 mg/kg per min) over 1-minute followed by a 4-minute maintenance infusion of 50 microgram/kg per min (0.05 mg/kg per min). In case a sufficient therapeutic effect is noticed over the 5-minutes of drug administration, maintenance infusion dosage should be maintained with periodic check as well as adjustments up/down as required. In case a sufficient therapeutic effect is not noticed, repeat the same loading dosage infusion over 1-minute and boost the maintenance infusion to 100 microgram/kg per min (0.1 mg/kg per min).


Continue procedure of titration as above, repeating the original loading esmolol dose of 500 microgram/kg per min (0.5 mg/kg per min) over 1-minute, and further boosting the maintenance infusion rate over the subsequent 4-minutes by 50 microgram/kg per min (0.05 mg/kg per min) enhancements. As the required heart rate or blood pressure is approached, decrease the maintenance infusion rate downward as appropriate. In case desired, increase the interval b/w steps from 5 to 10 minutes. The maintenance dosages more than 200 microgram/kg per minute (0.2 mg/kg per minute) have not been shown to have significantly boosted benefits and are not prescribed. The time-span between titration steps may be increased.


When Esmolol Should Not Be Used?


The esmolol 100 mg injection is not for use in chronic settings. This medicinal product should not be used in those patients:

  • who are with low blood pressure

  • who are with a slow heart rate

  • who are with heart block problems

  • who are with abnormally high blood pressure in the arteries of the lung

  • who are with a disease in the natural pacemaker (conduction system) of the heart

  • who are using medicines for managing heart conditions or maintain their blood pressure

  • who are with heart failure

  • who are with shock due to a decreased heart output

  • who are with an untreated tumour of the adrenal gland

  • who are allergic to esmolol HCL or any of the nonmedicinal ingredients


Interactions With Esmolol

Discuss with your health specialist in case you are taking any prescription and/or over the counter medicines while on treatment with esmolol 10mg/ml, especially the drugs listed below:

  • Drugs for treating high blood pressure including guanfacine, clonidine, moxonidine, and reserpine

  • Drugs for treating heart rhythm complications, chest pain (angina), or heart failure (e.g., diltiazem, verapamil, digoxin)

  • Drugs for treating diabetes, including insulin and medications taken by mouth

  • Tricyclic’ antidepressant medications (e.g. imipramine and amitriptyline) or any other drugs for treating mental health problems

  • Epinephrine, such as EpiPen Injection, which is prescribed for treating allergic reactions

  • Warfarin, which is prescribed to thin your blood

  • Morphine, which is known as a strong painkiller

  • Drugs for treating low blood pressure (e.g. epinephrine, norepinephrine, and dopamine) that are usually given at the hospital

  • Drugs for treating asthma (e.g. isoproterenol and terbutaline)

  • Suxamethonium chloride (also called scoline or succinylcholine), which is used to relax muscles, and inhalation anesthetics. Treatment with esmolol 100mg/10ml may prolong the effects of some medicines you may receive while on anesthesia and surgery.

  • Fingolimod, a medication approved for the treatment of multiple sclerosis


Storage and Availability of Esmolol

For vial, store this medicinal product at temperature 15°C to 25°C. For premixed bags store it at temperature 15°C to 25°C. Protect the drug from freezing. Excessive heating should be avoided. The esmolol price is reasonable and might vary depending on the availability of a wide range of generic and innovator brands. In order to procure the best quality esmolol, at the most promising price range, kindly connect to us at TOLL-FREE: 1800-889-1064. We're an authentic supplier of esmolol and other related medicinal products.


NOTE: Deets mentioned in this article about "Esmolol: An Intravenous Cardioselective Beta-1 Adrenergic Antagonist" is for informational or educational purposes only, and does not substitute professional medical advice or consultations with health specialists.


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