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Rapiblyk
landiolol
Adult Dosing .
Dosage forms: INJ
supraventricular tachycardia
- [normal cardiac function]
- Dose: 9-36 mcg/kg/min IV for up to 24h; Start: 9 mcg/kg/min IV, titrate by 9 mcg/kg/min IV q10min; Max: 36 mcg/kg/min; Info: taper dose gradually to D/C
- [impaired cardiac function]
- Dose: 1-36 mcg/kg/min IV for up to 24h; Start: 1 mcg/kg/min IV, titrate by 1 mcg/kg/min IV q15min; Max: 36 mcg/kg/min; Info: taper dose gradually to D/C
renal dosing
- [not defined]
- renal impairment: not defined
- HD/PD: not defined
hepatic dosing
- [see below]
- Child-Pugh Class A: consider decr. usual titration dose or frequency; Child-Pugh Class B or C: not defined
Peds Dosing .
- Dosage forms: INJ
supraventricular tachycardia
- [normal cardiac function]
- Dose: 9-36 mcg/kg/min IV for up to 24h; Start: 9 mcg/kg/min IV, titrate by 9 mcg/kg/min IV q10min; Max: 36 mcg/kg/min; Info: taper dose gradually to D/C
renal dosing
- [not defined]
- renal impairment: not defined
- HD/PD: not defined
hepatic dosing
- [see below]
- Child-Pugh Class A: consider decr. usual titration dose or frequency; Child-Pugh Class B or C: not defined
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- sinus bradycardia, severe
- sick sinus syndrome
- AV block, 2nd-3rd degree
- heart failure, decompensated
- cardiogenic shock
- pulmonary HTN
- abrupt withdrawal
- caution: anaphylactic reaction history, severe
- caution: renal impairment
- caution: hepatic impairment
- caution: AV block, 1st degree
- caution: sinus node dysfunction
- caution: cardiac conduction defect
- caution: reactive airway disease
- caution: CAD
- caution: Prinzmetal angina
- caution: pheochromocytoma
- caution: hypotension
- caution: hypovolemia
- caution: Raynaud phenomenon
- caution: PVD
- caution: hyperthyroidism
- caution: diabetes mellitus
- caution: surgery, major
- caution: fasting
Drug Interactions .
Overview
landiolol
beta blocker
- antihypertensive agent
- bradycardia
- delays atrioventricular conduction
- hyperkalemia
- hypotensive effects
Avoid/Use Alternative
- acebutolol
- adenosine
- albuterol
- albuterol inhaled
- aldesleukin
- alectinib
- alfentanil
- amiloride
- amiodarone
- amphetamine
- angiotensin II
- apraclonidine ophthalmic
- arformoterol inhaled
- armodafinil
- arsenic trioxide
- articaine
- atazanavir
- atenolol
- atomoxetine
- benzphetamine
- betaxolol
- betaxolol ophthalmic
- bisoprolol
- brigatinib
- bupivacaine
- bupivacaine liposomal
- bupropion
- carbamazepine
- carteolol ophthalmic
- carvedilol
- ceritinib
- chloroprocaine
- clonidine
- clozapine
- cocaine
- crizotinib
- desvenlafaxine
- dexmedetomidine
- dexmedetomidine injection
- dexmethylphenidate
- dextroamphetamine
- diethylpropion
- digoxin
- dihydroergotamine
- diltiazem
- disopyramide
- dobutamine
- donepezil
- dopamine
- doxapram
- dronedarone
- droxidopa
- dulaglutide
- eliglustat
- ensartinib
- ephedra
- ephedrine injection
- ephedrine oral
- epinephrine
- epinephrine inhaled
- ergotamine
- esketamine
- esmolol
- ethanol (alcoholic beverage)
- etrasimod
- fenfluramine
- fentanyl
- fexinidazole
- fingolimod
- flecainide
- formoterol inhaled
- fosphenytoin
- gadobenate dimeglumine
- galantamine
- guanfacine
- hoodia
- isocarboxazid
- ivabradine
- ketamine
- labetalol
- lacosamide
- lamotrigine
- lanreotide
- levalbuterol inhaled
- levobunolol ophthalmic
- levomilnacipran
- lidocaine
- linezolid
- lisdexamfetamine
- lisinopril
- lofexidine
- lopinavir/ritonavir
- lorlatinib
- mefloquine
- mepivacaine
- methamphetamine
- methylergonovine
- methylphenidate
- metoprolol
- midodrine
- milnacipran
- mirabegron
- modafinil
- nadolol
- nebivolol
- neostigmine
- nicotine
- norepinephrine
- octreotide
- olmesartan medoxomil
- olodaterol inhaled
- ozanimod
- pasireotide
- perindopril
- phendimetrazine
- phenelzine
- phentermine
- phenylephrine
- phenylephrine injection
- phenytoin
- pindolol
- ponesimod
- potassium chloride
- potassium phosphate
- praziquantel
- procainamide
- procarbazine
- propafenone
- propofol
- propranolol
- pseudoephedrine
- pyridostigmine
- quinidine (antiarrhythmic)
- quinine
- rasagiline
- regadenoson
- remifentanil
- remimazolam
- ritonavir
- rivastigmine
- ropinirole
- ropivacaine
- rotigotine transdermal
- safinamide
- salmeterol inhaled
- selegiline
- selegiline transdermal
- siponimod
- solriamfetol
- sotalol
- succinylcholine
- sufentanil
- sugammadex
- tacrolimus
- terbutaline
- thalidomide
- ticagrelor
- timolol
- timolol ophthalmic
- tranylcypromine
- valsartan
- vasopressin
- venlafaxine
- verapamil
- vilanterol inhaled
- viloxazine
- yohimbe
Monitor/Modify Tx
- alfuzosin
- aliskiren
- alprostadil intracavernous
- amantadine
- amifostine
- amitriptyline
- amlodipine
- amoxapine
- apomorphine
- aprocitentan
- aripiprazole bimonthly injection
- aripiprazole lauroxil
- aripiprazole monthly injection
- aripiprazole oral
- asenapine
- avanafil
- azilsartan medoxomil
- benazepril
- berberine
- bethanechol
- bexagliflozin
- bortezomib
- brexpiprazole
- brimonidine ophthalmic
- brimonidine topical
- bromocriptine
- bumetanide
- buprenorphine
- butorphanol
- cabergoline
- canagliflozin
- candesartan cilexetil
- cannabis
- captopril
- cariprazine
- celecoxib
- chlorothiazide
- chlorpromazine
- chlorthalidone
- cilostazol
- clevidipine
- clofarabine
- clomipramine
- codeine
- coenzyme Q-10
- cyclosporine
- dapagliflozin
- decitabine
- denileukin diftitox
- desflurane
- desipramine
- deutetrabenazine
- diclofenac
- diclofenac topical
- diflunisal
- dihydrocodeine
- dinutuximab
- dipyridamole
- doxazosin
- doxepin
- dronabinol
- drospirenone (contraceptive)
- drospirenone (hormone replacement)
- duloxetine
- empagliflozin
- enalapril
- enalaprilat
- entacapone
- entrectinib
- eplerenone
- epoprostenol
- ertugliflozin
- ethacrynic acid
- ethanol injection
- etodolac
- felodipine
- fenoldopam
- fenoprofen
- ferumoxytol
- finerenone
- flaxseed
- flibanserin
- fluphenazine
- flurbiprofen
- fosinopril
- foslevodopa
- furosemide
- garlic
- gilteritinib
- haloperidol
- heparin
- hydralazine
- hydrochlorothiazide
- hydrocodone
- hydromorphone
- ibuprofen
- iloperidone
- iloprost
- imipramine
- indapamide
- indomethacin
- irbesartan
- iron sucrose
- isoflurane
- isosorbide dinitrate
- isosorbide mononitrate
- isradipine
- ketoprofen
- ketorolac
- levodopa
- levorphanol
- losartan
- loxapine
- lubiprostone
- lumateperone
- lurasidone
- magnesium sulfate
- maraviroc
- meclofenamate
- mefenamic acid
- meloxicam
- meperidine
- methadone
- methohexital
- methyldopa
- methylene blue injection
- metolazone
- midazolam
- milrinone
- milsaperidone
- minoxidil
- mirtazapine
- moexipril
- molindone
- morphine
- nabumetone
- nalbuphine
- naphazoline ophthalmic
- naproxen
- nattokinase
- naxitamab
- niacin (vitamin B3)
- nicardipine
- nifedipine
- nilotinib
- nimodipine
- nisoldipine
- nitric oxide
- nitrite
- nitroglycerin
- nitroprusside
- nortriptyline
- obinutuzumab
- olanzapine
- oliceridine
- opicapone
- opium
- oxaprozin
- oxazepam
- oxycodone
- oxymetazoline nasal
- oxymetazoline ophthalmic
- oxymetazoline topical
- oxymorphone
- paliperidone
- palopegteriparatide
- paltusotine
- pentamidine
- pentazocine
- pentobarbital
- perphenazine
- phenobarbital
- phenoxybenzamine
- phentolamine
- phenylephrine nasal
- phenylephrine ophthalmic
- phenylephrine rectal
- piroxicam
- potassium acid phosphate
- potassium bicarbonate
- potassium citrate
- potassium iodide
- pramipexole
- prazosin
- prochlorperazine
- promethazine
- protriptyline
- quetiapine
- quinapril
- ramipril
- riociguat
- risperidone
- sacubitril
- sevoflurane
- sildenafil
- silodosin
- sodium ferric gluconate complex
- sotagliflozin
- sparsentan
- spironolactone
- sulindac
- tadalafil
- tagraxofusp
- tamsulosin
- tapentadol
- taurine
- telmisartan
- terazosin
- tetrabenazine
- tetrahydrozoline ophthalmic
- thioridazine
- thiothixene
- tizanidine
- tolcapone
- tolmetin
- tolvaptan
- torsemide
- tramadol
- trandolapril
- trazodone
- treprostinil
- triamterene
- trifluoperazine
- trimethoprim
- trimipramine
- valbenazine
- vardenafil
- vinpocetine
- voclosporin
- vosoritide
- ziprasidone
Adverse Reactions .
Serious Reactions
- CHF
- hypotension, severe
- bradycardia, severe
- heart block
- angina exacerbation if abrupt D/C
- MI if abrupt D/C
- ventricular arrhythmia if abrupt D/C
- hyperkalemia
- bronchospasm
Common Reactions
- hypotension
Safety/Monitoring .
Monitoring Parameters
electrolytes; BP; HR; ECG
Pregnancy/Lactation .
Pregnancy
Clinical Summary
weigh risk/benefit during pregnancy, especially in 2nd and 3rd trimesters; inadequate human data available, though possible risk of intrauterine growth restriction and neonatal adverse effects, including bradycardia, hypoglycemia and respiratory depression based on limited human data with other beta blockers; no known risk of embryo-fetal toxicity based on animal data at 2.7x MRHD
Lactation
Clinical Summary
monitor infant closely while breastfeeding; no human data available, though possible risk of infant bradycardia and hypoglycemia based on limited human data with other beta blockers and drug's mechanism of action; no human data available to assess effects on milk production
Pharmacology .
Metabolism: for landiolol: plasma; CYP450: unknown; Info: active metabolite
Excretion: for landiolol: urine 89-99%; Half-life: 4-5min
Subclass: Antiarrhythmics, Parenteral ; Beta Blockers
Mechanism of Action
for landiolol: selectively antagonizes beta-1 adrenergic receptors (class II antiarrhythmic)
Formulary .
No Formulary Selected
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