Esmolol Hydrochloride

Packaging- Vial Strength- 10mg/10ml

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Esmolol is a beta-adrenergic blocker used for the short-term treatment of:

  • Control of ventricular rate in supraventricular tachycardia including atrial fibrillation and atrial flutter and control of heart rate in noncompensatory sinus tachycardia.
  • Control of perioperative tachycardia and hypertension.

Dosage and Side Effects

    • The esmolol hydrochloride is administered by continuous intravenous infusion with or without a loading dose.
    • For patients with Supraventricular tachycardia (SVT) or noncompensatory sinus tachycardia, Optional loading dose is 500 mcg per kg infused over one minute, then 50 mcg per kg per minute for the next 4 minutes. Adjust dose as needed to a maximum of 200 mcg per kg per minute.
    • For patients with Perioperative tachycardia and hypertension, Loading dose is 500 mcg per kg over 1 minute for gradual control (1 mg per kg over 30 seconds for immediate control), then 50 mcg per kg per minute for gradual control (150 mcg per kg per minute for immediate control) adjusted to a maximum of 200 (tachycardia) or 300 (hypertension) mcg per kg per minute.

The most commonly reported esmolol side effects (incidence> 10%) include: symptomatic hypotension (dizziness, hyperhidrosis) and asymptomatic hypotension.

Warning and Precautions

  • Monitor patients closely, if pretreatment blood pressure is low. In case of an unacceptable drop in blood pressure, reduce or stop esmolol injection.
  • Concomitant use of beta blockers (esmolol) and antidiabetic agents can be responsible for enhancing the effect of antidiabetic agents (blood glucose–lowering).
  • Monitor vital signs precisely and titrate esmolol 10mg/ml slowly in the treatment of patients whose blood pressure is mainly driven by vasoconstriction associated with hypothermia.
  • Beta blockers, like esmolol, can cause depression of myocardial contractility and may precipitate heart failure and cardiogenic shock. At the first sign/symptom of impending cardiac failure, stop esmolol 100 mg injection and start supportive therapy.
  • Monitor respective patients for heart rate and rhythm in patients receiving treatment with esmolol.
  • Avoid infusions of esmolol into the small veins or through a butterfly catheter. In case a local infusion site reaction occurs, consider an alternative infusion site and avoid extravasation.
  • In hypovolemic patients, esmolol 100 mg injection can attenuate reflex tachycardia and increase the probability of hypotension.
  • In patients with peripheral circulatory disorders (including Raynaud’s disease or syndrome, and peripheral occlusive vascular disease), esmolol therapy may aggravate peripheral circulatory disorders.
  • Beta blockers, including esmolol hydrochloride, have been reported to cause hyperkalemic renal tubular acidosis. Acidosis in general can be associated with decreased cardiac contractility.


What is Esmolol 100mg/10ml Injection? The esmolol 100mg/10ml injection is a short-acting, cardio-selective beta receptor blocker, a class-II antiarrhythmic agent.  How is Esmolol Injection administered? Esmolol Injection comes as 100 mg/10 mL (10 mg/mL) Ready-to-use Vials, for intravenous administration.  How is Esmolol Injection metabolized? Esmolol Injection is metabolized via red blood cell cytosol esterases.  What dosage strengths of Esmolol HCL Premixed Injection are available?

Ready-to-use bags are available in 2 dosage strengths: Esmolol HCl 10 mg/mL and 20 mg/mL. After terminating the infusion of Esmolol Injection, how rapidly is the effect reversed?

Esmolol Injection has a 10-20 minute duration of action for rapid reversibility of beta-blockade after terminating infusion.