Parenteral Manual


Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Beta adrenergic blocking agent
Original Date: 
August 2005
Revised Date: 
September 2011
  • Perioperative management of hypertension
  • Supraventricular tachycardia (control ventricular rate in patients with sinus tachycardia)
Reconstitution and Stability: 
  • Clear, colorless to light yellow solution
  • Store at room temperature
  • Diluted solutions stable 7 days at room temperature or refrigerated


- Solutions Compatible: D5W, NS, dextrose-saline combinations, ringer's lactate

- Additives/Above Cassette Compatible: no information

- Y-site Compatible: ampicillin, clindamycin, dopamine, enalaprilat, fentanyl, metronidazole, morphine, potassium chloride

- Incompatible:  amphotericin B, furosemide, warfarin


(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

IV Direct

Usual dilution: 10 mg/mL
Infusion time: 1-2 minutes

IV Intermittent Infusion NO
IV Continuous Infusion YES
Usual dilution: 10 mg/mL

Click here to access SDC Drug Infusion Sheet


(For neonatal dosages, refer to Neonatal IV Drug Manual.)


  • Bolus/Loading dose: 100-500 mcg/kg over 1 minute, followed by an infusion; infusion rate = 100-500 mcg/kg/minute.  Maximum 1000 mcg/kg/minute
Potential hazards of parenteral administration: 
  • Phlebitis, skin necrosis after extravasation
  • Hypotension, bradycardia
  • Dizziness, flushing, diaphoresis, nausea
  • Bronchoconstriction
  • Onset of action (2-10 minutes)
  • Short duration of action (10-30 minutes)
  • Monitor blood pressure, EKG, heart rate, respiratory rate and IV site
  • Use with caution in patient with hyper-reactive airway disease
  • May increase digoxin or theophylline serum concentrations
  • Morphine may increase esmolol blood concentrations


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