Esmolol (Brevibloc) Considerations for Use*
US/FDA Approved Indication: Heart Rate Control for Atrial Fibrillation
|Black Box Warning*||Abrupt cessation may exacerbate angina pectoris and MI.|
Mechanism of Action
Blocks binding of catecholamines to beta-1 receptors; mainly beta-1 selective
Acute setting: 500 mcg/kg IV over 1 min, then 50 to 200 mcg/kg/min
Hepatic Impairment: No dosage adjustment needed
Renal Impairment: No dosage adjustment needed
|Major Side Effects||
hypotension, heart block, bradycardia, bronchospasm , HF
|Dosage forms and Strengths||
IV: 10 mg/mL , 20 mg/mL solution for injection
Half-life: 9 minutes
Esmolol infusions should not be abruptly discontinued; the infusion rate should be tapered
Avoid using butterfly needles and very small veins for infusion; infusion via central line is preferred when feasible
* Refer to prescribing information for more complete information.
†Dosages given in the table may differ from those recommended by the manufacturers.
- American College of Cardiology (ACC), American Heart Association (AHA), and the European Society of Cardiology (ESC). ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation. Washington, DC: American College of Cardiology.
- Heart Rhythm Society. AF360 Pocket Guide: Practical Rate and Rhythm Management of Atrial Fibrillation. 2010, Washington, DC: Heart Rhythm Society.
- Tarascon Pocket Pharmacopoeia® 2012.