Esmolol HCl (Intravenous)

Esmolol is used to control rapid heartbeats or abnormal heart rhythms. This medicine is also used to treat fast heartbeat and high blood pressure during surgery, after surgery, or during other medical procedures.

This medicine is a beta-blocker. It works by affecting how the body responds to nerve signals in certain areas, including the heart. As a result, the heart beats slower and blood pressure decreases. When blood pressure is lowered, the amount of blood and oxygen going to the heart increases.

This medicine is available only with your doctor's prescription.

Your doctor will give you only a few doses of this medicine until your condition gets better, and then you will be switched to another medicine that works similarly. If you have any questions about this, talk to your doctor.

In deciding to use a medicine, you and your doctor must consider the risks of taking the medicine compared to the benefits it may provide.

Allergies

Inform your doctor if you have ever had any unusual or allergic reactions to this medicine or any other medicines. Also, let your healthcare provider know if you have other allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, carefully read the label or package ingredients.

Pediatric

There have not been appropriate studies on the effects of esmolol in children. Its safety and effectiveness have not been established for this group.

Geriatric

There is no information available on how age affects the use of esmolol in older patients. However, elderly patients are more likely to have kidney problems related to aging, which may require adjusting the dose of esmolol.

Breast Feeding

There are no adequate studies in women to determine the risk to infants when using this medicine while breastfeeding. Consider the potential benefits and risks before taking this medicine during breastfeeding.

Interactions with Medicines

Some medicines should never be used together, while others may be used together even if there might be an interaction. If you are receiving this medicine, it is very important that your healthcare provider knows if you are taking any of the medicines listed below. The following interactions have been selected based on their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be necessary in some cases. If both medicines are prescribed, your doctor may adjust the dose or how often you take one or both.

• Albuterol
• Ceritinib
• Clonidine
• Crizotinib
• Darunavir
• Diltiazem
• Dronedarone
• Fenoldopam
• Fexinidazole
• Fingolimod
• Formoterol
• Indacaterol
• Iohexol
• Lacosamide
• Levalbuterol
• Olodaterol
• Ponesimod
• Rivastigmine
• Salmeterol
• Siponimod
• Terbutaline
• Verapamil
• Vilanterol

Using this medicine with any of the following may increase the risk of certain side effects, but using both may be the best treatment for you. If both are prescribed together, your doctor may change the dose or how often you take one or both.

• Acarbose
• Aceclofenac
• Acemetacin
• Acetyldigoxin
• Albiglutide
• Alfuzosin
• Alogliptin
• Amtolmetin Guacil
• Aspirin
• Bromfenac
• Bufexamac
• Bunazosin
• Canagliflozin
• Celecoxib
• Chlorpropamide
• Choline Salicylate
• Clonixin
• Dapagliflozin
• Deslanoside
• Dexibuprofen
• Dexketoprofen
• Diclofenac
• Diflunisal
• Digitoxin
• Digoxin
• Dipyrone
• Doxazosin
• Droxicam
• Dulaglutide
• Empagliflozin
• Ertugliflozin
• Etodolac
• Etofenamate
• Etoricoxib
• Exenatide
• Felbinac
• Fenoprofen
• Fepradinol
• Feprazone
• Floctafenine
• Flufenamic Acid
• Flurbiprofen
• Glimepiride
• Glipizide
• Glyburide
• Ibuprofen
• Indomethacin
• Insulin Aspart, Recombinant
• Insulin Degludec
• Insulin Detemir
• Insulin Glargine, Recombinant
• Insulin Glulisine
• Insulin Human Inhaled
• Insulin Human Isophane (NPH)
• Insulin Human Regular
• Insulin Lispro, Recombinant
• Ketoprofen
• Ketorolac
• Linagliptin
• Liraglutide
• Lixisenatide
• Lornoxicam
• Loxoprofen
• Lumiracoxib
• Meclofenamate
• Mefenamic Acid
• Meloxicam
• Metformin
• Metildigoxin
• Miglitol
• Morniflumate
• Morphine
• Morphine Sulfate Liposome
• Moxisylyte
• Nabumetone
• Naproxen
• Nateglinide
• Nepafenac
• Niflumic Acid
• Nimesulide
• Nimesulide Beta Cyclodextrin
• Oxaprozin
• Oxyphenbutazone
• Parecoxib
• Phenoxybenzamine
• Phentolamine
• Phenylbutazone
• Piketoprofen
• Pioglitazone
• Piroxicam
• Pramlintide
• Pranoprofen
• Prazosin
• Proglumetacin
• Propyphenazone
• Proquazone
• Repaglinide
• Rofecoxib
• Rosiglitazone
• Salicylic Acid
• Salsalate
• Saxagliptin
• Sitagliptin
• Sodium Salicylate
• St John's Wort
• Sulindac
• Tamsulosin
• Tenoxicam
• Terazosin
• Tiaprofenic Acid
• Tolazamide
• Tolbutamide
• Tolfenamic Acid
• Tolmetin
• Trimazosin
• Urapidil
• Valdecoxib
• Vildagliptin

Interactions with Food/Tobacco/Alcohol

Some medicines should not be taken with food or certain types of food because interactions may happen. Using alcohol or tobacco with some medicines may also cause interactions. Talk to your healthcare provider about using your medicine with food, alcohol, or tobacco.

Other Medical Problems

Having other medical problems may affect the use of this medicine. Make sure to inform your doctor if you have any other medical issues, especially:

• Bradycardia (slow heartbeat) or
• Heart block or
• Heart failure—This medicine should not be used in patients with these conditions.

• Diabetes or
• Hypoglycemia (low blood sugar)—This medicine may hide some signs and symptoms of these conditions, such as a fast heartbeat.

• Hypotension (low blood pressure)—This medicine may make this condition worse.

• Kidney disease—Use with caution, as the effects may be greater due to slower removal from the body.

• Lung disease (e.g. asthma, bronchitis, emphysema)—This medicine may cause breathing difficulties in patients with these conditions.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common

• Blurred vision
• confusion
• dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
• increased sweating
• unusual tiredness or weakness

Less common

• Itching of skin
• numbness and tingling of face, fingers, or toes
• pain in arms, legs, or lower back, especially pain in calves and/or heels upon exertion
• pale, bluish-colored, or cold hands or feet
• weak or absent pulses in legs

Rare

• Blue lips and fingernails
• burning, crawling, itching, numbness, prickling, "pins and needles," or tingling feelings
• changes in skin color
• changes in vision
• chest pain or discomfort
• convulsions
• coughing that sometimes produces a pink frothy sputum
• decrease in frequency of urination
• decrease in urine volume
• delusions
• dementia
• difficult, fast, noisy breathing, sometimes with wheezing
• difficulty in passing urine (dribbling)
• difficulty with speaking
• feeling of warmth
• feeling unusually cold
• lightheadedness, dizziness, or fainting
• loss of bladder control
• muscle spasm or jerking of all extremities
• no heartbeat
• pain, tenderness, or swelling of foot or leg
• painful urination
• paleness of skin
• peeling of skin
• redness of the face, neck, arms, and occasionally, upper chest
• shivering
• shortness of breath
• slow or irregular heartbeat
• small clicking, bubbling, or rattling sounds in the lung when listening with a stethoscope
• sudden loss of consciousness
• swelling, redness, or burning of skin where the needle is placed
• tightness in chest

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

• Dilated neck veins
• extreme fatigue
• irregular breathing
• no blood pressure or pulse
• stopping of heart
• swelling of face, fingers, feet, or lower legs
• unconsciousness
• weight gain

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• Hardening or thickening of skin where the needle is placed
• nausea

Less common

• Anxiety
• dry mouth
• headache
• hyperventilation
• irritability
• nervousness
• restlessness
• shaking
• sleepiness or unusual drowsiness
• trouble sleeping
• vomiting

Rare

• Acid or sour stomach
• belching
• change in taste or bad, unusual, or unpleasant (after) taste
• difficulty having a bowel movement (stool)
• discouragement
• feeling sad or empty
• heartburn
• indigestion
• lack of appetite
• lack or loss of strength
• loss of interest or pleasure
• shoulder pain
• stomach soreness, discomfort, upset, or pain
• stuffy nose
• tiredness
• trouble concentrating
• weight loss

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Brevibloc
• Esmolol HCl

Available Dosage Forms:

• Solution

Therapeutic Class: Cardiovascular Agent

Pharmacologic Class: Beta-Adrenergic Blocker, Cardioselective

A nurse or other trained health professional will give you this medicine. This medicine is given through a needle placed into one of your veins.