Esmolol
Esmolol is a short-acting, cardioselective beta-1 blocker administered intravenously in hospital settings to rapidly control heart rate and blood pressure. It is primarily used in acute cardiac situations where quick, titratable beta-blockade is needed, such as during surgery or for managing certain arrhythmias.
A rapid-acting IV beta-blocker used in hospitals to quickly control heart rate during acute cardiac events.
Key facts at a glance
- ATC
- C07AB09
- RxNorm
- 49737
- Generic
- Esmolol
- Class
- atc-c07
- Brands
- Brevibloc
- Availability
- rx
- Lactation
- unknown
- Routes
- —
- Forms
- injection, solution
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 500mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 250mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 400mg daily
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
7 groupspregnancy
first trimesteravoid if possible
avoid use during pregnancy unless benefits outweigh risks
regular fetal monitoring
Use with caution and monitor for adverse effects.
pregnancy
third trimesteruse lowest effective dose
close monitoring of fetal heart rate and uterine activity
continuous fetal monitoring
Use with caution and monitor for adverse effects.
lactation
breastfeedingno adjustment needed
consider interrupting breastfeeding for 24 hours after infusion
monitor infant for bradycardia
Use with caution and monitor for adverse effects.
pediatric_age
children under 18not recommended
not approved for use in pediatric patients
not established
Use of this medication in this population requires careful consideration of risks and benefits.
geriatric
elderly 65 yearsstart at lower end of dosing range
initiate therapy at low dose and titrate slowly, monitor blood pressure and heart rate closely
frequent vital sign monitoring
Use with caution and monitor for adverse effects.
renal_impairment
severe renal impairmentno adjustment required
no dose adjustment needed as esmolol is metabolized by blood esterases
standard monitoring
hepatic_impairment
severe hepatic impairmentno adjustment required
no dose adjustment needed as esmolol is not hepatically metabolized
standard monitoring
Statistics and clinical data
FDA Approval Year
FDA approval year for esmolol hydrochloride
Drug class
Pharmacological classification of esmolol
Common uses
Primary therapeutic indications for esmolol
Route of administration
Standard route of administration for esmolol
Used for rate control in supraventricular tachycardia (SVT), atrial fibrillation, and atrial flutter. Also indicated for acute heart rate and blood pressure control during surgical procedures and in postoperative settings.
Blocks beta-1 adrenergic receptors in the heart, reducing heart rate, contractility, and cardiac workload. Its beta-1 selectivity means it primarily affects the heart with minimal impact on beta-2 receptors in the lungs and blood vessels.
Administered only by IV in monitored hospital settings due to its rapid onset and short duration of action. Requires careful titration. Contraindicated in patients with severe bradycardia, heart block without a pacemaker, decompensated heart failure, or hypotension. May cause bronchospasm in susceptible patients despite its selectivity.
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed July 26, 2026. · Read our editorial policy