Products
Esmolol is commercially available as an injection and infusion solution (Brevibloc, generic). It has been approved in many countries since 1990.
Structure and properties
Esmolol (C16H25NO4, Mr = 295.4 g/mol) is present in drugs as esmolol hydrochloride, a racemate and a white crystalline powder that is highly soluble in water. It is rapidly biotransformed in the body by ester hydrolysis to the free acid and methanol. The metabolites are pharmacologically inactive.
Effects
Esmolol (ATC C07AB09) lowers blood pressure and heart rate. It is a selective blocker of beta1 adrenergic receptors with a rapid onset and short duration of action. It is a so-called soft drug. The half-life is only about 9 minutes. Esmolol has no intrinsic sympathomimetic or membrane-stabilizing activity.
Indications
For rapid reduction of ventricular rate in patients with atrial fibrillation, atrial flutter, and sinus tachycardia. For supraventricular tachycardia and/or hypertension during and after surgery and in other emergencies.
Dosage
According to the SmPC. The drug is administered intravenously.
Contraindications
For complete precautions, see the drug label.
Adverse effects
The most common potential adverse effect is symptomatic or asymptomatic hypotension.
