esmolol

Adult Dosing .

Dosage forms:  INJ

supraventricular tachycardia

[50-300 mcg/kg/min IV for up to 48h]

Start: 500 mcg/kg/dose IV x1; Info: for immediate rate control; consider repeat loading dose before each dose incr; taper dose gradually to D/C

noncompensatory sinus tachycardia

[50-300 mcg/kg/min IV for up to 48h]

Start: 500 mcg/kg/dose IV x1; Info: for immediate rate control; consider repeat loading dose before each dose incr; taper dose gradually to D/C

atrial fibrillation/flutter

[50-300 mcg/kg/min IV for up to 48h]

Start: 500 mcg/kg/dose IV x1; Info: for immediate rate control; consider repeat loading dose before each dose incr; taper dose gradually to D/C

HTN or tachycardia, intraop/postop

[immediate rate control]

Dose: 1000 mcg/kg/dose IV x1, then 150 mcg/kg/min IV prn; Max: 200 mcg/kg/min for tachycardia; 300 mcg/kg/min for HTN; Info: may continue infusion and incr. dose by 50 mcg/kg/min q4min prn; taper dose gradually to D/C

[gradual rate control]

Dose: 500 mcg/kg/dose IV x1, then 50 mcg/kg/min IV x4min; Max: 200 mcg/kg/min for tachycardia; 300 mcg/kg/min for HTN; Info: may continue infusion and incr. dose by 50 mcg/kg/min q4min prn; taper dose gradually to D/C

hypertensive crisis (off-label)

[50-200 mcg/kg/min IV]

Start: 500-1000 mcg/kg/dose x1, then 50 mcg/kg/min IV, then may incr. by 50 mcg/kg/min prn; Max: 200 mcg/kg/min

renal dosing

[see below]

renal impairment: no adjustment; Info: elevated metabolite levels in ESRD

HD/PD: no adjustment; no supplement; Info: elevated metabolite levels in ESRD

hepatic dosing

[not defined]

Peds Dosing .

Dosage forms:  INJ

supraventricular tachycardia (off-label)

[25-350 mcg/kg/min IV]

Start: 500 mcg/kg/dose IV x1, then 25-200 mcg/kg/min IV; Max: 1000 mcg/kg/min; Info: dosing protocols vary, individualize dose; may incr. dose by 25-50 mcg/kg/min q5-10min; taper dose gradually to D/C

HTN or tachycardia, intraop/postop (off-label)

[25-350 mcg/kg/min IV]

Start: 500 mcg/kg/dose IV x1, then 25-200 mcg/kg/min IV; Max: 1000 mcg/kg/min; Info: dosing protocols vary, individualize dose; may incr. dose by 25-50 mcg/kg/min q5-10min; taper dose gradually to D/C

HTN, acute severe (off-label)

[100-500 mcg/kg/min IV]

Start: 100-500 mcg/kg/dose IV x1, then 50-150 mcg/kg/min IV; Max: 1000 mcg/kg/min; Info: for pts w/ life-threatening sx; dosing protocols vary, individualize dose; may titrate to effect q10-15min; taper dose gradually to D/C

renal dosing

[not defined]

renal impairment: consider adult renal dosing for guidance

HD/PD: consider adult renal dosing for guidance

hepatic dosing

[not defined]