Disclaimer:
Medidex is not a provider of medical services and all information is provided for the convenience of the user. No medical decisions should be made based on the information provided on this website without first consulting a licensed healthcare provider.This website is intended for persons 18 years or older. No person under 18 should consult this website without the permission of a parent or guardian.
Esmolol
Overview
What is Esmolol?
Ready-to-use Vials10 mL VialsIso-Osmotic Solution of Esmolol Hydrochloride in Sodium Chloride
Esmolol Hydrochloride concentration = 10 milligrams/mL (10,000 micrograms/mL)
DESCRIPTION
Esmolol hydrochloride has the empirical formula C16H26NO4Cl and a molecular weight of 331.8. It has one asymmetric center and exists as an enantiomeric pair. Esmolol hydrochloride is a white to off-white crystalline powder. It is a relatively hydrophilic compound which is very soluble in water and freely soluble in alcohol. Its partition coefficient (octanol/water) at pH 7.0 is 0.42 compared to 17.0 for propranolol. Esmolol Hydrochloride Injection Esmolol Hydrochloride Injection is a clear, colorless to light yellow, sterile, nonpyrogenic, iso-osmotic solution of esmolol
hydrochloride in sodium chloride. 100 mg, 10 mL Single Dose Vial– Each mL contains 10 mg Esmolol Hydrochloride, 5.9 mg Sodium Chloride, USP and Water for Injection, USP; buffered with 2.8 mg Sodium Acetate Trihydrate, USP and 0.546 mg Glacial Acetic Acid, USP. Sodium Hydroxide and/or Hydrochloric Acid added, as necessary to adjust pH to 5.0 (4.5-5.5).
What does Esmolol look like?
What are the available doses of Esmolol?
Sorry No records found.
What should I talk to my health care provider before I take Esmolol?
Sorry No records found
How should I use Esmolol?
Supraventricular Tachycardia
Intraoperative and Postoperative Tachycardia and/or Hypertension
Dosing Information:
SUPRAVENTRICULAR TACHYCARDIA
*As the desired heart rate or endpoint is approached, the loading infusion may be omitted and the maintenance infusion titrated to 300 mcg/kg/min (0.3 mg/kg/min) or downward as appropriate. Maintenance dosages above 200 mcg/kg/min (0.2 mg/kg/min) have not been shown to have significantly increased benefits. The interval between titration steps may be increased. In the treatment of supraventricular tachycardia, responses to esmolol hydrochloride usually (over 95%) occur within the range of 50 to 200 micrograms/kg/min (0.05 to 0.2 milligrams/kg/min). The average effective dosage is approximately 100 micrograms/kg/ min (0.1 milligrams/kg/min) although dosages as low as 25 micrograms/kg/min (0.025 milligrams/kg/min) have been adequate in some patients. Dosages as high as 300 micrograms/kg/min (0.3 milligrams/kg/min) have been used, but these provide little added effect and increase the rate of adverse effects, so doses greater than 200 micrograms/kg/min are not recommended. Dosage of esmolol hydrochloride in supraventricular tachycardia must be individualized by titration in which each step consists of a loading dosage followed by a maintenance dosage.This specific dosage regimen has not been studied intraoperatively and, because of the time required for titration, may not be optimal for intraoperative use.The safety of dosages above 300 mcg/kg/min (0.3 mg/kg/min) has not been studied.In the event of an adverse reaction, the dosage of esmolol hydrochloride may be reduced or discontinued. If a local infusion site reaction develops, an alternate infusion site should be used and caution should be taken to prevent extravasation. The use of butterfly needles should be avoided.Abrupt cessation of esmolol hydrochloride in patients has not been reported to produce the withdrawal effects which may occur with abrupt withdrawal of beta blockers following chronic use in coronary artery disease (CAD) patients. However, caution should still be used in abruptly discontinuing infusions of esmolol hydrochloride in CAD patients.After achieving an adequate control of the heart rate and a stable clinical status in patients with supraventricular tachycardia, transition to alternative antiarrhythmic agents such as propranolol, digoxin, or verapamil, may be accomplished.A recommended guideline for such a transition is given below but the physician should carefully consider the labeling instructions for the alternative agent selected.
The dosage of esmolol hydrochloride should be reduced as follows:1. Thirty minutes following the first dose of the alternative agent, reduce the infusion rate of esmolol hydrochloride by one-half (50%).2. Following the second dose of the alternative agent, monitor the patient’s response and if satisfactory control is maintained for the first hour, discontinue esmolol hydrochloride.The use of infusions of esmolol hydrochloride up to 24 hours has been well documented; in addition, limited data from 24-48 hrs(N=48) indicate that esmolol hydrochloride is well tolerated up to 48 hours.
In the intraoperative and postoperative settings it is not always advisable to slowly titrate the dose of esmolol hydrochloride to a therapeutic effect. Therefore, two dosing options are presented: immediate control dosing and a gradual control when the physician has time to titrate.1. Immediate ControlFor intraoperative treatment of tachycardia and/or hypertension give an 80 mg (approximately 1 mg/kg) bolus dose over 30 seconds followed by a 150 mcg/kg/min infusion, if necessary. Adjust the infusion rate as required up to 300 mcg/kg/min to maintain desired heart rate and/or blood pressure.2. Gradual ControlFor postoperative tachycardia and hypertension, the dosing schedule is the same as that used in supraventricular tachycardia. To initiate treatment, administer a loading dosage infusion of 500 mcg/kg/min of esmolol hydrochloride for one minute followed by a four-minute maintenance infusion of 50 mcg/kg/min. If an adequate therapeutic effect is not observed within five minutes, repeat the same loading dosage and follow with a maintenance infusion increased to 100 mcg/kg/min (see above SUPRAVENTRICULAR TACHYCARDIA).
:1. Higher dosages (250-300 mcg/kg/min) may be required for adequate control of blood pressure than those required for the treatment of atrial fibrillation, flutter and sinus tachycardia. One third of the postoperative hypertensive patients required these higher doses.2. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.
This dosage form is prediluted to provide a ready-to-use, iso-osmotic solution of 10 mg/mL esmolol hydrochloride in sodium chloride recommended for esmolol hydrochloride intravenous administration. It may be used to administer the appropriate esmolol hydrochloride loading dosage infusions by hand-held syringe while the maintenance infusion is being prepared.The 10 mL Ready-to-use Vial esmolol hydrochloride at a concentration of 10 milligrams/mL. When using a 10 milligrams/mL concentration, a loading dose of 0.5 mg/kg infused over 1 minute period of time, for a 70 kg patient is 3.5 mL.
Esmolol hydrochloride was tested for compatibility with ten commonly used intravenous fluids at a final concentration of 10 mgEsmolol Hydrochloride per mL. Esmolol hydrochloride was found to be compatible with the following solutions and was stable for at least 24 hours at controlled room temperature or under refrigeration:• Dextrose (5%) Injection, USP• Dextrose (5%) in Lactated Ringer’s Injection• Dextrose (5%) in Ringer’s Injection• Dextrose (5%) and Sodium Chloride (0.45%) Injection, USP• Dextrose (5%) and Sodium Chloride (0.9%) Injection, USP• Lactated Ringer’s Injection, USP• Potassium Chloride (40 mEq/liter) in Dextrose (5%) Injection, USP• Sodium Chloride (0.45%) Injection, USP• Sodium Chloride (0.9%) Injection, USPEsmolol hydrochloride is NOT compatible with Sodium Bicarbonate (5%) Injection, USP.
What interacts with Esmolol?
Sorry No Records found
What are the warnings of Esmolol?
Sorry No Records found
What are the precautions of Esmolol?
Sorry No Records found
What are the side effects of Esmolol?
Sorry No records found
What should I look out for while using Esmolol?
Esmolol hydrochloride is contraindicated in patients with sinus bradycardia, heart block greater than first degree, cardiogenic shock or overt heart failure (see ).
Hypotension
Cardiac Failure
Intraoperative and Postoperative Tachycardia and/or Hypertension
Diabetes Mellitus and Hypoglycemia
What might happen if I take too much Esmolol?
Acute Toxicity
Bradycardia
Bronchospasm
Cardiac Failure
Symptomatic Hypotension
How should I store and handle Esmolol?
Store at 20° to 25°C (68° to 77°F). [See USP Controlled Room Temperature.]PHARMACIST:Store at 20° to 25°C (68° to 77°F). [See USP Controlled Room Temperature.]PHARMACIST:Esmolol Hydrochloride InjectionNDC 0641-2965-45, 100 mg - 10 mL Ready-to-use Vials, Package of 25 Avoid excessive heat.Baxter is a registered trademark of Baxter International Inc.Manufactured by Deerfield, IL 60015 USAFor Product Inquiry 1 800 ANA DRUG (1-800-262-3784)Rev: April 2005
Clinical Information
Chemical Structure
No Image foundClinical Pharmacology
Esmolol hydrochloride is a beta1-selective (cardioselective) adrenergic receptor blocking agent with rapid onset, a very short duration of action, and no significant intrinsic sympathomimetic or membrane stabilizing activity at therapeutic dosages. Its elimination halflife after intravenous infusion is approximately 9 minutes. Esmolol hydrochloride inhibits the beta1 receptors located chiefly in cardiac muscle, but this preferential effect is not absolute and at higher doses it begins to inhibit beta2 receptors located chiefly in the bronchial and vascular musculature.
Pharmacokinetics and Metabolism
Pharmacodynamics
Supraventricular Tachycardia
Non-Clinical Toxicology
Esmolol hydrochloride is contraindicated in patients with sinus bradycardia, heart block greater than first degree, cardiogenic shock or overt heart failure (see ).Hypotension
Cardiac Failure
Intraoperative and Postoperative Tachycardia and/or Hypertension
Diabetes Mellitus and Hypoglycemia
Catecholamine-depleting drugs (eg, reserpine) may have an additive effect when given with beta-blocking agents. Patients treated with TENORMIN plus a catecholamine depletor should therefore be closely observed for evidence of hypotension and/or marked bradycardia which may produce vertigo, syncope, or postural hypotension.
Calcium channel blockers may also have an additive effect when given with TENORMIN (See ).
Disopyramide is a Type I antiarrhythmic drug with potent negative inotropic and chronotropic effects. Disopyramide has been associated with severe bradycardia, asystole and heart failure when administered with beta blockers.
Amiodarone is an antiarrhythmic agent with negative chronotropic properties that may be additive to those seen with beta blockers.
Beta blockers may exacerbate the rebound hypertension which can follow the withdrawal of clonidine. If the two drugs are coadministered, the beta blocker should be withdrawn several days before the gradual withdrawal of clonidine. If replacing clonidine by beta-blocker therapy, the introduction of beta blockers should be delayed for several days after clonidine administration has stopped.
Concomitant use of prostaglandin synthase inhibiting drugs, eg, indomethacin, may decrease the hypotensive effects of beta blockers.
Information on concurrent usage of atenolol and aspirin is limited. Data from several studies, ie, TIMI-II, ISIS-2, currently do not suggest any clinical interaction between aspirin and beta blockers in the acute myocardial infarction setting.
While taking beta blockers, patients with a history of anaphylactic reaction to a variety of allergens may have a more severe reaction on repeated challenge, either accidental, diagnostic or therapeutic. Such patients may be unresponsive to the usual doses of epinephrine used to treat the allergic reaction.
Both digitalis glycosides and beta-blockers slow atrioventricular conduction and decrease heart rate. Concomitant use can increase the risk of bradycardia.
General
Drug Interactions
Carcinogenesis, Mutagenesis, Impairment of Fertility
Pregnancy Category C
Nursing Mothers
Pediatric Use
The following adverse reaction rates are based on use of esmolol hydrochloride in clinical trials involving 369 patients with supraventricular tachycardia and over 600 intraoperative and postoperative patients enrolled in clinical trials. Most adverse effects observed in controlled clinical trial settings have been mild and transient. The most important adverse effect has been hypotension (see WARNINGS). Deaths have been reported in post-marketing experience occurring during complex clinical states where esmolol hydrochloride was presumably being used simply to control ventricular rate (see WARNINGS, Cardiac Failure).
Cardiovascular
Central Nervous System
Respiratory
Gastrointestinal
Skin (Infusion Site)
Miscellaneous
Reference
This information is obtained from the National Institute of Health's Standard Packaging Label drug database.
"https://dailymed.nlm.nih.gov/dailymed/"
While we update our database periodically, we cannot guarantee it is always updated to the latest version.
Review
Read user comments about the side effects, benefits, and effectiveness of losartan oral.
Overall User Ratings
514Total User Reviews
User Reviews
Learn about
User Reviews
Professional
Clonazepam Description Each single-scored tablet, for oral administration, contains 0.5 mg, 1 mg, or 2 mg Clonazepam, USP, a benzodiazepine. Each tablet also contains corn starch, lactose monohydrate, magnesium stearate, microcrystalline cellulose, and povidone. Clonazepam tablets USP 0.5 mg contain Yellow D&C No. 10 Aluminum Lake. Clonazepam tablets USP 1 mg contain Yellow D&C No. 10 Aluminum Lake, as well as FD&C Blue No. 1 Aluminum Lake. Chemically, Clonazepam, USP is 5-(o-chlorophenyl)-1,3-dihydro-7-nitro-2H-1,4-benzodiazepin-2-one. It is a light yellow crystalline powder. It has the following structural formula: C15H10ClN3O3 M.W. 315.72Tips
Tips
Interactions
Interactions
A total of 440 drugs (1549 brand and generic names) are known to interact with Imbruvica (ibrutinib). 228 major drug interactions (854 brand and generic names) 210 moderate drug interactions (691 brand and generic names) 2 minor drug interactions (4 brand and generic names) Show all medications in the database that may interact with Imbruvica (ibrutinib).