Last update July 30, 2022

Esmolol Hydrochloride

Likely Compatibility

Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.

It is an ultrashort-acting cardioselective β1-adrenergic blocker used for the treatment of supraventricular tachycardia and perioperative hypertension and/or tachycardia. There is some evidence that it reduces intraoperative and postoperative pain and opioid use (Gelineau 2018, Watts 2017). Intravenous administration.

At the date of the last update we did not find any published data on its excretion in breast milk.

Although its low protein binding can facilitate the passage into breast milk (Riant 1986), its high volume of distribution, its low lipid solubility and its very short half-life (9 minutes) make its excretion in breast milk very unlikely.

Its low oral bioavailability makes it difficult for it to pass to the infant plasma from ingested breast milk, except in premature infants and in the immediate neonatal period in which there may be greater intestinal permeability.

Until more published data is known about this drug in relation to breastfeeding, known safer alternatives are preferable, especially during the neonatal period and in the event of prematurity.

Alternatives

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Esmolol Hydrochloride in other languages or writings:

Groups

Esmolol Hydrochloride belongs to these groups or families:

Tradenames

Main tradenames from several countries containing Esmolol Hydrochloride in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. Baja - Low %
Molecular weight 332 daltons
Protein Binding 55 %
VD 3.5 l/Kg
pKa 14.09 -
Tmax 0.25 hours
0.15 hours

References

  1. Gelineau AM, King MR, Ladha KS, Burns SM, Houle T, Anderson TA. Intraoperative Esmolol as an Adjunct for Perioperative Opioid and Postoperative Pain Reduction: A Systematic Review, Meta-analysis, and Meta-regression. Anesth Analg. 2018 Mar;126(3):1035-1049. Abstract Full text (link to original source)
  2. AEMPS. Esmolol. Ficha técnica. 2018 Full text (in our servers)
  3. Watts R, Thiruvenkatarajan V, Calvert M, Newcombe G, van Wijk RM. The effect of perioperative esmolol on early postoperative pain: A systematic review and meta-analysis. J Anaesthesiol Clin Pharmacol. 2017 Jan-Mar;33(1):28-39. Abstract Full text (link to original source)
  4. Tamargo Menéndez J, Delpón Mosquera E. Farmacología de los bloqueantes de los receptores β-adrenérgicos. Curso βeta 2011 de Actualización en Betabloqueantes. 2011 Full text (in our servers)
  5. Riant P, Urien S, Albengres E, Duche JC, Tillement JP. High plasma protein binding as a parameter in the selection of betablockers for lactating women. Biochem Pharmacol. 1986 Abstract

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