BREVIBLOC (Esmolol Hydrochloride) is a beta1-selective (cardioselective) adrenergic receptor blocking agent with a very short duration of action (elimination half-life is approximately 9 minutes). Esmolol Hydrochloride is:
BREVIBLOC (Esmolol Hydrochloride) is indicated for the rapid control of ventricular rate in patients with atrial fibrillation or atrial flutter in perioperative, postoperative, or other emergent circumstances where short term control of ventricular rate with a short-acting agent is desirable. BREVIBLOC is also indicated in noncompensatory sinus tachycardia where, in the physician's judgment, the rapid heart rate requires specific intervention. BREVIBLOC is not intended for use in chronic settings where transfer to another agent is anticipated.
BREVIBLOC (Esmolol Hydrochloride) is indicated for the treatment of tachycardia and hypertension that occur during induction and tracheal intubation, during surgery, on emergence from anesthesia, and in the postoperative period, when in the physician's judgment such specific intervention is considered indicated.
Use of BREVIBLOC to prevent such events is not recommended.
Published Studies Related to Brevibloc (Esmolol)
A randomised study of perioperative esmolol infusion for haemodynamic stability during major vascular surgery; rationale and design of DECREASE-XIII. [2011.09]
OBJECTIVES: This article describes the rationale and design of the DECREASE-XIII trial, which aims to evaluate the potential of esmolol infusion, an ultra-short-acting beta-blocker, during surgery as an add-on to chronic low-dose beta-blocker therapy to maintain perioperative haemodynamic stability during major vascular surgery. DESIGN: A double-blind, placebo-controlled, randomised trial... CONCLUSIONS: This study will provide data on the efficacy of esmolol titration in chronic beta-blocker users for tight heart-rate control and reduction of ischaemia in patients undergoing vascular surgery as well as data on safety parameters. Copyright (c) 2011 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
[A comparative study on the efficacy and safety of intravenous esmolol, amiodarone and diltiazem for controlling rapid ventricular rate of patients with atrial fibrillation during anesthesia period]. [2010.11]
OBJECTIVE: To evaluate the efficacy and safety of intravenous esmolol, amiodarone and diltiazem for controlling rapid ventricular rate in patients with atrial fibrillation (AF) during anesthesia period... CONCLUSIONS: Intravenous esmolol, amiodarone and diltiazem are all equally effective and safe on controlling rapid ventricular rate in patients with atrial fibrillation during the anesthesia period. Esmolol use is associated with the shortest mean reacting time and amiodarone use is associated with the lowest total side effect rate in this patient cohort.
[Effect of intravenous esmolol on BIS index and anesthesia emergence during sedation anesthesia for ambulatory surgery]. [2010.06.15]
CONCLUSION: Esmolol combined with propofol administering in minor ambulatory operations can control the increase of BIS index caused by surgical nociceptive stimulus. Meanwhile the combination could reduce the dose of sedatives and decrease anesthesia emergence time.
Esmolol reduces perioperative ischemia in noncardiac surgery: a meta-analysis of randomized controlled studies. [2010.04]
OBJECTIVE: Literature increasingly has suggested how beta-blockers could be associated with reductions of mortality and morbidity in noncardiac surgery. Recently, the POISE trial showed that beta-blockers could be harmful in the perioperative period. The authors performed a meta-analysis to evaluate the clinical effects of esmolol in noncardiac surgery... CONCLUSIONS: Esmolol seemed to reduce the incidence of myocardial ischemia in noncardiac surgery without increasing the episodes of hypotension and bradycardia. Large randomized trials are necessary to confirm these promising results. Copyright (c) 2010 Elsevier Inc. All rights reserved.
Attenuation of hemodynamic responses to laryngoscopy and tracheal intubation during rapid sequence induction: remifentanil vs. lidocaine with esmolol. [2010.03]
AIM: This study was designed to compare the effectiveness of remifentanil vs. a lidocaine-esmolol combination in blunting the hemodynamic response to laryngoscopy and intubation during rapid sequence induction using thiopental and rocuronium in normotensive patients... CONCLUSION: The results of this study show that remifentanil 1 mg/kg is more effective than the combination of lidocaine 1.5 mg/kg and esmolol 1 mg/kg for attenuating the hemodynamic responses to rapid sequence intubation.
Clinical Trials Related to Brevibloc (Esmolol)
Long-term PK and Safety/Tolerability Testing LDLL600 Against Esmolol in Healthy Volunteers [Recruiting]
The study will compare the pharmacokinetics (PK), safety and tolerability of long-term
infusion of lyophilized landiolol (LDLL600) against esmolol (Brevibloc) by measurement of
blood concentrations of landiolol, esmolol and their metabolites, and by monitoring systemic
cardiovascular and local tolerability, blood pressure (BP), ECG including heart rate (HR)
and adverse events (AEs).
Esmolol for Treatment of Perioperative Tachycardia [Recruiting]
Heart Rate Control With Esmolol in Septic Shock [Recruiting]
The purpose of this study is investigate the effects on systemic hemodynamics and organ
function of esmolol when used to maintain heart rate below a predefined threshold in
patients with septic shock.
Esmolol or Nitroglycerin Infusion for Blood Pressure Control Prior to Cardiopulmonary Bypass (CPB) in Cardiac Surgery [Recruiting]
This is an investigator initiated, sponsored, open label, prospective randomized controlled
trial to be performed in adult patients undergoing scheduled cardiac surgery. Patients will
be randomized to esmolol infusion or nitroglycerin infusion for control of hypertension that
occurs during cardiac surgery from induction of anesthesia to initiation of cardiopulmonary
Tight Hemodynamic Control in Patients Who Are Chronically on Metoprolol [Recruiting]
This study proposes to assess the effect of the standard of care, which is continuation of
the pre op beta blocker dose into the post operative period compared to the administration
of esmolol titrated to a pre determined target HR. The primary outcome will compare
postoperative plasma levels of metoprolol in 2 cohorts in a group who has been continued on
metoprolol (administrated via a nasogastric tube in NPO patients) to a group who has been
withdrawn from metoprolol but given an esmolol infusion titrated to HR. Secondary outcomes
will compare a) the hemodynamic responses, documenting the incidence of unplanned
hypotension and bradycardia and b) to compare the effects of Heart rate to the incidence of
myocardial ischemia, arrhythmias, delirium and infarction.