Esmolol

Drug Levels and Effects:




Summary of Use during Lactation:


Based on its physicochemical properties and extremely short half-life, esmolol would not be expected to cause any adverse effects in breastfed infants.


Drug Levels:


The excretion ofbeta-adrenergic blocking drugs into breastmilk is largely determined by their protein binding. Those with low binding are more extensively excreted into breastmilk.[1] Accumulation of the drugs in the infant is related to the fraction excreted in urine. With 55% protein binding, less than 1% renal excretion and an extremely short half-life of less than 10 minutes, esmolol presents no risk for accumulation in infants.

Maternal Levels.

Relevant published information was not found as of the revision date.

Infant Levels.

Relevant published information was not found as of the revision date.


Effects in Breastfed Infants:


A study of mothers takingbeta-blockers during nursing found a numerically, but not statistically significant increased number of adverse reactions in those taking anybeta-blocker. Although the ages of infants were matched to control infants, the ages of the affected infants were not stated. None of the mothers were taking esmolol.[2]


Possible Effects on Lactation:


Relevant published information on the effects ofbeta-blockade or esmolol during normal lactation was not found as of the revision date. A study in 6 patients with hyperprolactinemia and galactorrhea found no changes in serum prolactin levels followingbeta-adrenergic blockade with propranolol.[3]


Alternate Drugs to Consider:


Propranolol,Labetalol,Metoprolol


References:


1. Riant P, Urien S, Albengres E et al. High plasma protein binding as a parameter in the selection of betablockers for lactating women. Biochem Pharmacol. 1986;35:4579-81. PMID:2878668
2. Ho TK, Moretti ME, Schaeffer JK et al. Maternalbeta-blocker usage and breast feeding in the neonate. Pediatr Res. 1999;45:67A. Abstract 385.
3. Board JA, Fierro RJ, Wasserman AJ et al. Effects of alpha- andbeta-adrenergic blocking agents on serum prolactin levels in women with hyperprolactinemia and galactorrhea. Am J Obstet Gynecol. 1977;127:285-7. PMID:556882



Substance Identification:




Substance Name:

Esmolol

CAS Registry Number:

81147-92-4

Drug Class:


  • Antihypertensive Agents

  • Adrenergic
  • Beta
  • -Antagonists

  • Antirrhythmics


  • Administrative Information:




    LactMed Record Number:


    289


    Last Revision Date:


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