Bedside Snapshot

Use It For: AF or flutter with rapid ventricular response (stable, no pre-excitation); perioperative tachycardia and hypertension; acute aortic dissection (heart rate first); noncompensatory sinus tachycardia
Adult Dose: Rate control: 50 mcg/kg/min after optional 500 mcg/kg IV load; max 300 mcg/kg/min
Differs from FDA label: label max 200 mcg/kg/min
Perioperative: 1 mg/kg IV over 30 sec, then 150 mcg/kg/min; max 300 for BP
Pediatric Dose: Not established in children; no pediatric dose shown. Specialist use only
Onset / Duration: IV: steady state within 5 min with a loading dose (about 30 min without) / substantial recovery 10–20 min after stopping; half-life about 9 min
Do Not Give / Hold If: Severe sinus bradycardia, AV block above first degree or sick sinus; decompensated HF or cardiogenic shock; pre-excited AF; pulmonary hypertension; recent IV verapamil or diltiazem. Hold for SBP <90 mmHg
Watch For: Hypotension (BP before every titration); bradycardia or AV block (continuous ECG); heart failure (crackles, falling SpO₂); bronchospasm (wheeze)
Reversal / Rescue: No antidote: stop the infusion (effect fades in 10–20 min). Atropine or pacing for bradycardia; fluids and vasopressors for hypotension; glucagon or high-dose insulin if shock persists
Must Remember: Never make your own bolus dilution: dilution errors have caused fatal overdoses. Use the premixed bag or ready-to-use vial, run mcg/kg/min on a smart pump and confirm 10 vs 20 mg/mL

Indications

ED / ICU / Transport

AF or flutter with rapid ventricular response: Stable, no pre-excitation. Reach for an IV β-blocker or a nondihydropyridine calcium channel blocker first (AHA 2025, 2023 AF guideline)
AF after cardiac surgery: A β-blocker is your first rate-control choice
Other supraventricular tachycardias: Rate control is the move when vagal maneuvers and adenosine fail, or when the rhythm keeps coming back
Noncompensatory sinus tachycardia: Treat the rate only when the rate itself needs treating
Perioperative tachycardia and hypertension: induction, intubation, surgery, emergence and recovery (not for prevention)
Acute aortic dissection and other acute aortic syndromes: Start anti-impulse therapy before any vasodilator. First-line, and off-label

Other Uses

Pheochromocytoma: Only after an α-blocker is running (FDA label §5.9)
Thyroid storm: β-blockade is the cornerstone. In suspected thyrotoxic cardiomyopathy, hypotension or evolving cardiogenic shock, esmolol is preferred over propranolol, because it can be switched off (off-label)
Shock-refractory VF or pulseless VT: The benefit is uncertain per AHA 2025 (COR 2b). This is not standard ACLS (off-label)

Not for cocaine toxicity: Don't give β-blockers, esmolol included, for cocaine-induced coronary vasospasm or hypertensive emergency in adults. AHA 2025 says no (COR 3: No Benefit). Severe agitation gets sedation, such as benzodiazepines. Coronary vasospasm or hypertensive emergency gets vasodilators instead: nitrates, phentolamine or calcium channel blockers.

Dosing & Administration

Two sets of doses sit below: the 2025 AHA rate-control dose and the FDA label doses. Check the final order against your order set.

Available Forms

Ready-to-use vial: 10 mg/mL in 10 mL (100 mg), for loading doses
Premixed bag: 10 mg/mL in 250 mL (2,500 mg); the usual ED, ICU and transport infusion
Double Strength premixed bag: 20 mg/mL in 100 mL (2,000 mg)
No form needs dilution; all are iso-osmotic and preservative-free

High-Alert Medication: Dilution errors have caused fatal overdoses. The overdose boluses ran 625 mg–2.5 g, or 12.5–50 mg/kg. Use the premixed bag or vial. Then check each one independently: concentration (10 vs 20 mg/mL), dosing weight, mcg/kg/min units and pump rate at start, at every bag change and at handoff.

Adult Dosing

Indication	Dose & Route	Repeat / Max	Notes
AF/flutter or SVT rate control; noncompensatory sinus tachycardia	Optional load 500 mcg/kg IV over 1 min, then 50 mcg/kg/min IV infusion for 4 min; usual maintenance 50–300 mcg/kg/min IV	If response is inadequate, repeat the load (optional) and raise the infusion by 50 mcg/kg/min every 4 min; max 300 mcg/kg/min	High-alert Average effective dose about 100 mcg/kg/min; doses as low as 25 mcg/kg/min have been adequate. Differs from FDA label: label max for rate control is 200 mcg/kg/min, because above 200 adds little slowing and more hypotension. May run up to 48 hr
Perioperative tachycardia or hypertension: immediate control	1 mg/kg IV bolus over 30 sec, then 150 mcg/kg/min IV infusion if needed	Titrate to HR and BP; max 200 mcg/kg/min for tachycardia, 300 mcg/kg/min for hypertension	High-alert Above 300 mcg/kg/min not studied. Titrate slowly if hypothermia drives the hypertension
Perioperative tachycardia or hypertension: gradual control	500 mcg/kg IV over 1 min, then 50 mcg/kg/min IV infusion for 4 min	Step up as for rate control; max 200 mcg/kg/min for tachycardia, 300 mcg/kg/min for hypertension	High-alert Not for prophylaxis of perioperative tachycardia or hypertension
Acute aortic dissection or other acute aortic syndrome (off-label)	500 mcg/kg IV over 1 min, then 50 mcg/kg/min IV infusion, titrated every 4 min	Target HR 60–80 bpm and SBP <120 mmHg (or lowest BP that keeps end organs perfused); max 300 mcg/kg/min	High-alert Arterial line. Caution in acute aortic regurgitation (new diastolic murmur or AR on echo), heart block or bradycardia. Add clevidipine or nicardipine only after β-blockade. If β-blockers are contraindicated or not tolerated, IV diltiazem or verapamil is reasonable
Thyroid storm (off-label)	500 mcg/kg IV over 1 min, then infusion titrated up to 200 mcg/kg/min	Max 200 mcg/kg/min	High-alert Start low in heart failure or hypotension. Part of the full storm regimen (thionamide, iodine 1 hr later, hydrocortisone); specialist guidance

Dosing weight: the label does not name actual or ideal weight. Use your protocol's weight, one per patient, and state it at handoff.

Pediatric Dosing

Not established in children: the FDA label says pediatric safety and effectiveness are not established. No pediatric dose is shown, because no source gives one. Pediatric cardiac intensive care use is specialist use only, and so is any other use. The order goes like this: a dose from AHA/AAP 2025 if it gives one, then the NASEMSO National Model EMS Clinical Guidelines v3.0 (2022), then the US label. If none of them gives a dose, none is shown. A pediatric maximum never goes above the adult maximum (NASEMSO Universal Care Guideline, p. 13). Doses are off-label unless marked labeled. For pediatric tachyarrhythmias in the field, follow PALS and medical control. See weight-based dosing.

Continuous Infusion

Setting	Example Concentration	Start	Titrate	Usual Range / Max
Rate control	10 mg/mL premixed bag (2,500 mg/250 mL)	50 mcg/kg/min, with or without a load	Up by 50 mcg/kg/min, no sooner than every 4 min	50–300 mcg/kg/min; max 300 mcg/kg/min
Blood pressure control	10 mg/mL bag, or 20 mg/mL Double Strength to limit volume	50 mcg/kg/min, or 150 mcg/kg/min after a 1 mg/kg bolus	No sooner than every 4 min	250–300 mcg/kg/min may be needed; max 300 mcg/kg/min

Pump rate (weight-based)

mL/hr = dose (mcg/kg/min) × weight (kg) × 60 ÷ concentration (mcg/mL). Example, 10 mg/mL (10,000 mcg/mL): 50 mcg/kg/min × 80 kg × 60 ÷ 10,000 = 24 mL/hr; 200 mcg/kg/min = 96 mL/hr

Preparation & Administration

Loading dose: by syringe from the vial, or withdrawn from the premixed bag's medication port (for that initial bolus only). 500 mcg/kg in an 80-kg adult is 40 mg (4 mL of 10 mg/mL).
Push rate: 500 mcg/kg over 1 min; 1 mg/kg over 30 sec only for immediate perioperative control.
Bag handling: add nothing; after a bolus is withdrawn, use within 24 hr; never connect bags in series (air embolism).
Line: a large vein, not small veins or butterfly needles; extravasation can cause necrosis.
Pump requirement: smart pump, esmolol library entry in mcg/kg/min.
Transition to another agent: 30 min after its first dose, halve the esmolol rate; after its second dose, stop esmolol if control has held for 1 hr.

Dosing Notes: The AHA's 2025 Guidelines for CPR and ECC, Part 9, rate-control table lists 50–300 mcg/kg/min. The FDA label is different. It caps rate control at 200 mcg/kg/min, since higher rates add little slowing and more hypotension. Titrate to response. Watch the blood pressure the whole way.

Contraindications & Precautions

Contraindications

Severe sinus bradycardia, sick sinus syndrome, heart block above first degree
Decompensated heart failure or cardiogenic shock
IV verapamil or diltiazem in close proximity (while either is still acting)
Pulmonary hypertension
Pre-excited AF or flutter (WPW): An AV nodal blocker can trigger VF. AHA 2025 and the 2023 AF guideline both list this as harm.
Hypersensitivity to esmolol or its product components. Cross-sensitivity with other β-blockers is possible.

Precautions

Reactive airway disease: Generally avoid β-blockers here. If you use one, go with the lowest effective dose and stop at the first wheeze.
Acute aortic regurgitation (e.g., type A dissection): Slowing the rate lengthens diastole, and that can worsen regurgitation. Use cautiously.
Prinzmetal (vasospastic) angina: It may make attacks worse (FDA label §5.8).
Peripheral vascular disease, Raynaud's: It may aggravate them (FDA label §5.11).
Metabolic acidosis: It lowers contractility. Hyperkalemic renal tubular acidosis has been reported (FDA label §5.14).
Hypovolemia: It blunts the compensatory tachycardia, so the hypotension runs deeper.
Pheochromocytoma: only after α-blockade (FDA label §5.9).
Cocaine-induced vasospasm or hypertensive emergency: Do not use. AHA 2025 recommends against β-blockers here (see Indications).
Diabetes, fasting patients, children: It masks and worsens hypoglycemia.
Coronary disease, hyperthyroidism: Taper it. An abrupt stop risks ischemia or thyroid storm. HR rises moderately above baseline about 30 min after stopping.
Anaphylaxis risk: It may blunt the response to epinephrine.

Hold / Reassess If

SBP <90 mmHg or hypoperfusion: reduce or stop.
HR below goal, pause or new AV block: reduce or stop.
Crackles, falling SpO₂ or wheeze: stop.

Esmolol plus IV calcium channel blocker: Fatal cardiac arrests have happened with esmolol and IV verapamil together. Keep IV diltiazem and verapamil away from esmolol, and esmolol away from them, until the first drug has stopped acting.

Adverse Effects & Toxicity

Common

Asymptomatic hypotension (about 25%)
Symptomatic hypotension with sweating or dizziness (about 12%)
Infusion site inflammation or induration (about 8%)
Nausea (about 7%)
Dizziness, somnolence (about 3% each); confusion, agitation, headache (about 2%)

Serious / Life-Threatening

Effect	Recognition	Management
Severe hypotension	SBP <90 mmHg, poor perfusion; dose-related	Reduce or stop; fluids or vasopressor. Most resolves within 30 min of stopping
Bradycardia, AV block, sinus arrest	Falling rate, pauses, high-grade block on ECG	Stop; atropine or pacing; ACLS if arrest
Heart failure or cardiogenic shock	Crackles, hypoxia, falling BP and perfusion	Stop at the first sign; inotrope or vasopressor
Bronchospasm	Wheeze	Stop; inhaled β₂-agonist
Infusion site necrosis	Pain, redness, blistering after extravasation	Stop and move to a larger vein

Overdose & Toxicity Management

Signs: bradycardia, AV block, hypotension, shock, asystole or PEA; seizures, respiratory depression, bronchospasm, hyperkalemia, hypoglycemia.
Immediate: stop the infusion (half-life about 9 min) and support the circulation until the drug clears.
Support: atropine or pacing; IV fluids; vasopressors such as norepinephrine or epinephrine (COR 1).
Refractory shock, per AHA 2025 β-blocker poisoning guidance: high-dose insulin/euglycemia therapy (COR 1), 1 unit/kg IV, then 1–10 units/kg/hr, with dextrose to keep glucose normal (check glucose frequently; watch K⁺ and volume status); glucagon 2–10 mg IV (COR 2a; pediatric 0.05–0.15 mg/kg, not above the adult dose), then 1–15 mg/hr in adults (expect vomiting); calcium may be reasonable (COR 2b); ECLS if refractory to drugs (COR 2a)."

Monitoring

Parameter	When / How Often	Target / Act If
Clinical: blood pressure	Before every titration (titrate no sooner than every 4 min), then per protocol; arterial line for aortic dissection or labile BP (see Hemodynamic Monitoring)	SBP <90 mmHg or hypoperfusion: reduce or stop. Aortic syndrome: SBP <120 mmHg
Clinical: heart rate and rhythm	Continuous ECG	AF with RVR (no HF): symptom-guided, generally resting HR <100–110 bpm; a stricter target (<80 bpm at rest) may be reasonable with suspected AF-induced cardiomyopathy or refractory HF symptoms. AF after cardiac surgery: HR <100 bpm. Aortic syndrome: HR 60–80 bpm. Pause, new AV block or HR below goal: reduce or stop
Clinical: perfusion	Each reassessment and after every titration: mental status, skin, capillary refill, urine output; lactate per protocol	Worsening perfusion (confusion, cool mottled skin, falling urine output, rising lactate): reduce or stop
Clinical: heart failure signs	Each reassessment: lung sounds, SpO₂, work of breathing	Crackles, falling SpO₂ or rising oxygen need: stop esmolol
Clinical: airway	Each reassessment in asthma or COPD	Wheeze: stop; inhaled β₂-agonist
Laboratory: potassium	Baseline and during therapy, more often in renal failure or hemodialysis	Rising K⁺: reassess; treat hyperkalemia per protocol
Laboratory: glucose	In diabetes, children and fasting or vomiting patients	Hypoglycemia (tachycardia may be absent): give dextrose per protocol
Infusion safety: IV site	Every assessment and after every move	Redness, swelling or pain: stop and move to a larger vein
Infusion safety: pump and bag	At start, every bag change and handoff	Concentration (10 vs 20 mg/mL), weight and mcg/kg/min must match the order

Interactions & Compatibility

Clinically Significant Interactions

Drug / Class	Effect	What To Do
IV verapamil or diltiazem	Severe bradycardia, AV block, cardiac arrest (fatal cases with verapamil)	Contraindicated in close proximity; wait until the first drug has worn off
Epinephrine, norepinephrine, dopamine infusions	Contractility falls against high vascular resistance	Label: do not use esmolol to control tachycardia in patients on these drugs
Digoxin, amiodarone, other AV nodal or negative inotropic drugs	Additive bradycardia and AV block; digoxin levels rise about 10–20%	Continuous ECG; lower doses; slower titration
Anesthetics, sedatives, other antihypertensives	Additive hypotension	Titrate one drug at a time
Succinylcholine, mivacurium	Prolonged neuromuscular blockade	Monitor neuromuscular function
Clonidine, guanfacine, moxonidine	Rebound hypertension if these are withdrawn during β-blockade	Stop the β-blocker first, gradually
Epinephrine for anaphylaxis; β-agonists	Reduced response to usual epinephrine doses; β-agonists counteract esmolol	Refractory anaphylaxis on a β-blocker: after epinephrine and IV fluids, AHA 2025 supports IV glucagon 1–5 mg in adults or 20–30 mcg/kg in children (max 1 mg)

IV Compatibility

Compatible at 10 mg/mL for at least 24 hr: D5W, 0.9% and 0.45% NaCl, lactated Ringer's, KCl 40 mEq/L in D5W and common dextrose-saline or dextrose-Ringer's mixtures.
Incompatible: Sodium bicarbonate 5% gives limited stability, and furosemide precipitates. Avoid contact with alkalis.
Verify with an institutional compatibility resource.

Special Populations

Pediatrics: the FDA label says safety and effectiveness are not established. Children carry a higher risk of hypoglycemia on β-blockade. See the Pediatric Dosing section.
Pregnancy: There are no adequate human studies. High-dose rabbit studies showed more fetal resorptions, and rat studies showed no teratogenicity. Third-trimester or labor use has caused fetal bradycardia that lasted after the infusion stopped. Do not withhold it in a maternal emergency. Involve obstetrics.
Lactation: Excretion into human milk is unknown. The label advises deciding whether to stop nursing or stop the drug, weighing how much the drug matters to the mother (half-life about 9 min).
Older Adults: Start at the low end of the range. Older patients bring more renal and cardiac impairment, and more interacting drugs.
Renal Impairment: No dose adjustment for 150 mcg/kg/min for 4 hr. There are no data for higher or longer infusions. The inactive acid metabolite builds up in end-stage kidney disease (half-life about 48 hr). Watch K⁺ in hemodialysis patients.
Hepatic Impairment: No special precautions. Red blood cell esterases do the metabolizing.
Obesity / Dosing Weight: The label gives no guidance on actual vs ideal weight. Follow your protocol consistently.
Heart Failure: Contraindicated when decompensated. In AF with LVEF <40% (HFrEF), diltiazem and verapamil are harmful (2023 AF guideline). If β-blockers are unsuitable too, amiodarone or digoxin are the options.

Field & Transport Considerations

Scope: Mostly ED, ICU and critical-care transport (RN, CCT paramedic), running as an infusion at transfer. Ground EMS rarely carries it. Varies by state and agency protocol.
Storage & Stability: Store at 25°C (77°F), with excursions 15–30°C (59–86°F). Keep it away from freezing and vehicle heat, and keep bags in the overwrap until use.
Carried Concentration: Confirm 10 mg/mL (250 mL bag or vial) or 20 mg/mL (100 mL Double Strength). A library mismatch silently doubles or halves the dose.
Infusions in Transport: Give it a dedicated pump channel. Work out how long the bag lasts: a 250 mL bag at 96 mL/hr runs out in about 2.5 hr. Keep a spare bag for long transfers. Reassess BP before and after every move.
Handoff Essentials: indication and HR/BP goals, load given (time, dose), current rate in mcg/kg/min, dosing weight, concentration, last titration and response, other nodal blockers or vasodilators running, and oral transition plan.

Clinical Pearls

Wide, irregular and very fast? Think pre-excited AF: Esmolol, and every other AV nodal blocker, can push WPW-conducted AF into VF. If unstable, cardiovert. If stable, reach for procainamide or ibutilide.

Aortic dissection: rate before pressure: Get the heart rate to 60–80 bpm with esmolol first. Then add a vasodilator if SBP is still above 120 mmHg. Alone, a vasodilator causes reflex tachycardia and raises aortic wall stress. Listen for a new diastolic murmur first. In acute aortic regurgitation, slowing the heart can make the regurgitation worse.

Do not treat compensatory tachycardia: Sinus tachycardia from sepsis, bleeding, hypoxia or pain is what keeps cardiac output up. In septic shock on norepinephrine, the similar drug landiolol did not reduce organ failure. The trial stopped early for possible harm.

A β-blocker you can switch off: A fragile patient can show you whether they tolerate β-blockade. The 9-minute half-life means you can stop it quickly. Skip the load, start at the low end of the range, and stop at the first sign of hypotension or heart failure.

Esmolol vs metoprolol vs diltiazem for AF with RVR:

Esmolol: An infusion with offset in 10–20 min. Best when tolerance is uncertain, or when rate and BP both need titrating
Metoprolol: An IV bolus that lasts hours. Simple, but it can't be switched off
Diltiazem: Fast and effective, with more vasodilation. Harmful when LVEF is <40% (HFrEF)

Exam discriminator: A tachycardic patient on an epinephrine, norepinephrine or dopamine infusion should not get esmolol for rate control (label). Find the cause of the tachycardia, or reduce the catecholamine, before you block β-receptors.

Pharmacology

Mechanism of Action

Competitive β₁-blockade at the SA node, AV node and myocardium. The rate slows, AV conduction slows and contractility falls. That gives you rate control and lower myocardial oxygen demand.
Lower heart rate and dP/dt means less shear stress on the aortic wall in acute aortic syndromes.
Relative β₁-selectivity: It is not absolute. β₂-blockade in the bronchi and vessels shows up at higher doses. At therapeutic doses there is no intrinsic sympathomimetic or membrane-stabilizing activity.

Pharmacokinetics

Route	Onset	Peak	Duration
IV (load + infusion)	Within minutes	Steady state within 5 min with a load; about 30 min without	Substantial recovery 10–20 min after stopping; hemodynamics at baseline by about 30 min

Half-life: distribution about 2 min; elimination about 9 min.
Metabolism: Ester hydrolysis happens in the red blood cell cytosol, by esterases, not plasma cholinesterase. Clearance is about 20 L/kg/hr, faster than cardiac output, so liver or kidney blood flow does not limit it.
Active metabolites: None. The acid metabolite has negligible activity (half-life about 3.7 hr), and the methanol produced stays near endogenous levels.
Elimination: Under 2% leaves unchanged in urine. The acid metabolite is excreted by the kidneys.
Protein binding: about 55%; hydrophilic.

Names & Classification

Generic Name: Esmolol hydrochloride
Brand Names: Brevibloc, Brevibloc Premixed, Brevibloc Premixed Double Strength (US); generic vials and premixed bags
Pharmacologic Class: Ultra-short-acting, cardioselective (β₁-selective) adrenergic blocker; Vaughan Williams class II
Therapeutic Class: Rate-control agent; IV antihypertensive (perioperative)
Controlled Substance: Not controlled
ISMP High-Alert: Yes: ISMP high-alert medication (adrenergic antagonists, IV)
Look-Alike / Sound-Alike: Brevibloc / Brevital (methohexital), on the ISMP confused drug names list

References

Baxter Healthcare Corporation. (2026). BREVIBLOC (esmolol hydrochloride) injection, for intravenous use: prescribing information. DailyMed, U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=595cc3d5-1306-4828-aefa-5595219ffd62
Joglar, J. A., Chung, M. K., Armbruster, A. L., Benjamin, E. J., et al. (2024). 2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation. Circulation, 149(1), e1–e156. https://doi.org/10.1161/CIR.0000000000001193
Wigginton, J. G., Agarwal, S., Bartos, J. A., Coute, R. A., et al. (2025). Part 9: Adult advanced life support: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 152(16 Suppl 2), S538–S577. https://doi.org/10.1161/CIR.0000000000001376
Cao, D., Arens, A. M., Chow, S. L., Easter, S. R., et al. (2025). Part 10: Adult and pediatric special circumstances of resuscitation: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 152(16 Suppl 2), S578–S672. https://doi.org/10.1161/CIR.0000000000001380
Isselbacher, E. M., Preventza, O., Hamilton Black, J., Augoustides, J. G., et al. (2022). 2022 ACC/AHA guideline for the diagnosis and management of aortic disease. Circulation, 146(24), e334–e482. https://doi.org/10.1161/CIR.0000000000001106
Taylor, P., Okosieme, O., Effraimidis, G., Gibb, F., et al. (2026). Management of thyroid emergencies: Joint consensus statement on management of thyroid storm. European Thyroid Journal, 15(4), ETJ260043. https://doi.org/10.1530/ETJ-26-0043
Whitehouse, T., Hossain, A., Perkins, G. D., Gordon, A. C., et al. (2023). Landiolol and organ failure in patients with septic shock: The STRESS-L randomized clinical trial. JAMA, 330(17), 1641–1652. https://doi.org/10.1001/jama.2023.20134
Institute for Safe Medication Practices. (2024). ISMP list of high-alert medications in acute care settings. ISMP/ECRI. https://www.ismp.org/system/files/resources/2024-01/ISMP_HighAlert_AcuteCare_List_010924_MS5760.pdf
Institute for Safe Medication Practices. (2024). ISMP list of confused drug names (updated through June 2024). ISMP/ECRI. https://online.ecri.org/hubfs/ISMP/Resources/ISMP_ConfusedDrugNames.pdf

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