Esmolol, Injection

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KEY POINTS

• This medicine is given by injection to treat high blood pressure, and to treat irregular or fast heartbeat.
• Keep all appointments for tests to see how this medicine affects you.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: beta blocker

Generic and brand names: esmolol, injection; Brevibloc

What is this medicine used for?

This medicine is given by injection to:

• Treat irregular or fast heartbeat
• Treat high blood pressure, especially during or after surgery

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before you take this medicine, be sure to tell your healthcare provider if you have ever had:

• An allergic reaction to any other medicine
• A lung disease such as asthma or COPD that causes shortness of breath, coughing, wheezing, or other breathing problems. (This medicine may make these problems worse.)
• A stroke or transient ischemic attack (TIA)
• Depression
• Diabetes
• Heart failure, a heart attack, or any other heart problems
• Kidney disease
• Low blood pressure
• Muscle disease such as myasthenia gravis
• Pheochromocytoma (a tumor of the adrenal gland)
• Problems with blood circulation such as Raynaud's disease or peripheral vascular disease
• Psoriasis
• Pulmonary hypertension
• Thyroid problems

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

Check with your healthcare provider before using this medicine in children under age 18 years.

A healthcare provider will give the IV infusions (slow drip through a needle into a large vein).

What should I watch out for?

Your healthcare provider may want you to check your pulse regularly. Report any unusual slowing or irregularity of your heart rate.

This medicine may cover up a fast heart rate caused by an overactive thyroid gland. Talk with your healthcare provider about this.

If you have severe pain at the site of the injection while you are receiving this medicine, let your healthcare provider know right away.

Follow your healthcare provider’s instructions about diet and a safe exercise program while you are taking this medicine.

This medicine may make you drowsy or dizzy or cause blurred vision. Do not drive or operate machinery unless you are fully alert and can see clearly. You may also feel dizzy or faint when you get up quickly after sitting or lying down. Getting up slowly may help.

Talk to your healthcare provider before you use any nasal decongestants or take cold medicines, including nonprescription products.

Adults over the age of 65 may be at greater risk for side effects. Talk with your healthcare provider about this.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

If you have diabetes: This medicine may affect your blood sugar and cover up the symptoms of low blood sugar. It may be harder to tell if your blood sugar level is too low or too high. Talk with your healthcare provider about this. Be sure you understand how this medicine might affect you and what to do if you have a problem.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; tightness in your chest; trouble breathing; swelling of your face, throat, or tongue).

Serious (Report these to your healthcare provider right away.): Chest pain; confusion; depression; slow or irregular heartbeat; severe dizziness or fainting; severe sweating; trouble breathing.

Other: Dizziness, drowsiness, tiredness, weakness, headache, constipation, nausea, vomiting, nervousness; injection site pain, redness, or swelling.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• ACE inhibitors such as benazepril (Lotensin), captopril, enalapril (Vasotec), fosinopril, lisinopril (Prinivil, Zestril), quinapril (Accupril), and ramipril (Altace)
• Alpha blockers such as alfuzosin (Uroxatral), doxazosin (Cardura), silodosin (Rapaflo), and tamsulosin (Flomax)
• Angiotensin receptor blockers (ARBs) such as azilsartan (Edarbi), candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar), olmesartan (Benicar), telmisartan (Micardis), and valsartan (Diovan)
• Antidepressants such as amitriptyline, clomipramine, desipramine (Norpramin), duloxetine (Cymbalta), fluoxetine (Prozac), fluvoxamine (Luvox), imipramine (Tofranil), nortriptyline (Pamelor), sertraline (Zoloft), and trazodone
• Antipsychotic medicines such as asenapine (Saphris), chlorpromazine, clozapine (Clozaril, FazaClo), haloperidol (Haldol), iloperidone (Fanapt), paliperidone (Invega), perphenazine, pimozide (Orap), prochlorperazine (Compro), quetiapine (Seroquel), thioridazine, trifluoperazine, and ziprasidone (Geodon)
• Barbiturates such as butabarbital (Butisol), pentobarbital (Nembutal), phenobarbital, and secobarbital (Seconal)
• Cancer medicines such as ceritinib (Zykadia) and rituximab (Rituxan)
• Clonidine (Catapres, Kapvay)
• Cough, cold, or allergy medicines such as diphenhydramine (Benadryl), phenylephrine (Neo-Synephrine, Sudafed PE), and pseudoephedrine (Sudafed)
• Diabetes medicines such as canagliflozin (Invokana), glipizide (Glucotrol), glyburide (Glynase), insulin, metformin (Fortamet, Glucophage, Riomet), pioglitazone (Actos), repaglinide (Prandin), rosiglitazone (Avandia), sitagliptin (Januvia), and tolbutamide
• Dipyridamole (Persantine)
• Diuretics (water pills) such as amiloride, bumetanide, chlorthalidone, ethacrynic acid (Edecrin), furosemide (Lasix), hydrochlorothiazide (Microzide), spironolactone (Aldactone), and torsemide (Demadex)
• Epinephrine (Adrenalin, Asthmanefrin, Auvi-Q, EpiPen)
• Erectile dysfunction medicines such as avanafil (Stendra), sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra, Staxyn)
• Ergot medicines such as dihydroergotamine (D.H.E. 45, Migranal), ergotamine (Ergomar), and methylergonovine
• Fingolimod (Gilenya)
• Heart or blood pressure medicines such as amiodarone (Cordarone, Pacerone), digoxin (Lanoxin), diltiazem (Cardizem, Cartia, Tiazac), disopyramide (Norpace), dofetilide (Tikosyn), dronedarone (Multaq), felodipine, flecainide, hydralazine, isradipine (DynaCirc), ivabradine (Corlanor), nicardipine (Cardene), nifedipine (Adalat CC, Procardia), prazosin (Minipress), procainamide, propafenone (Rythmol), quinidine, reserpine, terazosin, and verapamil (Calan, Covera, Verelan)
• Levothyroxine (Levo-T, Levothroid, Levoxyl, Synthroid, Unithroid)
• MAO inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate) (Do not take this medicine and an MAO inhibitor within 14 days of each other.)
• Medicines to treat breathing or lung problems such as albuterol (ProAir, Proventil, Ventolin), aminophylline, arformoterol (Brovana), formoterol (Perforomist), indacaterol (Arcapta), metaproterenol, salmeterol (Serevent), terbutaline, theophylline, and zileuton (Zyflo)
• Natural remedies such as bayberry, black cohosh, blue cohosh, California poppy, cayenne, dong quai, ephedra, garlic, ginger, ginseng, goldenseal, hawthorn, kola, licorice, ma huang, shepherd's purse, St. John's wort, and yohimbe
• Nitrate medicines such as isosorbide (Dilatrate, Isordil, Monoket) and nitroglycerin (Minitran, Nitro-Dur, Nitrostat)
• Nonsteroidal anti-inflammatory medicines (NSAIDs) such as celecoxib (Celebrex), diclofenac (Cambia, Voltaren, Zipsor), ibuprofen (Advil, Motrin), indomethacin (Indocin), ketoprofen, ketorolac, nabumetone (Relafen), naproxen (Aleve, Anaprox, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)
• Rifampin (Rifadin)
• Stimulants such as amphetamine/dextroamphetamine (Adderall), dextroamphetamine (Dexedrine), and methamphetamine (Desoxyn)

Do not drink alcohol while you are taking this medicine unless your healthcare provider approves.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.