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Esmolol Side Effects

In Summary

Commonly reported side effects of esmolol include: dizziness, hypotension, symptomatic hypotension, and diaphoresis. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to esmolol: intravenous solution

In addition to its needed effects, some unwanted effects may be caused by esmolol. In the event that any of these side effects do occur, they may require medical attention.

If any of the following side effects occur while taking esmolol, check with your doctor or nurse immediately:

More common:
  • Blurred vision
  • confusion
  • dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
  • increased sweating
  • unusual tiredness or weakness
Less common:
  • Itching of skin
  • numbness and tingling of face, fingers, or toes
  • pain in arms, legs, or lower back, especially pain in calves and/or heels upon exertion
  • pale, bluish-colored, or cold hands or feet
  • weak or absent pulses in legs
  • Blue lips and fingernails
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • changes in skin color
  • changes in vision
  • chest pain or discomfort
  • convulsions
  • coughing that sometimes produces a pink frothy sputum
  • decrease in frequency of urination
  • decrease in urine volume
  • delusions
  • dementia
  • difficult, fast, noisy breathing, sometimes with wheezing
  • difficulty in passing urine (dribbling)
  • difficulty with speaking
  • feeling of warmth
  • feeling unusually cold
  • lightheadedness, dizziness, or fainting
  • loss of bladder control
  • muscle spasm or jerking of all extremities
  • no heartbeat
  • pain, tenderness, or swelling of foot or leg
  • painful urination
  • paleness of skin
  • peeling of skin
  • redness of the face, neck, arms and occasionally, upper chest
  • shivering
  • shortness of breath
  • slow or irregular heartbeat
  • small clicking, bubbling, or rattling sounds in the lung when listening with a stethoscope
  • sudden loss of consciousness
  • swelling, redness, or burning of skin where the needle is placed
  • tightness in chest

If any of the following symptoms of overdose occur while taking esmolol, get emergency help immediately:

Symptoms of overdose:
  • Dilated neck veins
  • extreme fatigue
  • irregular breathing
  • no blood pressure or pulse
  • stopping of heart
  • swelling of face, fingers, feet, or lower legs
  • unconsciousness
  • weight gain

Minor Side Effects

Some of the side effects that can occur with esmolol may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common:
  • Hardening or thickening of skin where the needle is placed
  • nausea
Less common:
  • Anxiety
  • dry mouth
  • headache
  • hyperventilation
  • irritability
  • nervousness
  • restlessness
  • shaking
  • sleepiness or unusual drowsiness
  • trouble sleeping
  • vomiting
  • Acid or sour stomach
  • belching
  • change in taste or bad, unusual, or unpleasant (after) taste
  • difficulty having a bowel movement (stool)
  • discouragement
  • feeling sad or empty
  • heartburn
  • indigestion
  • lack of appetite
  • lack or loss of strength
  • loss of interest or pleasure
  • shoulder pain
  • stomach soreness, discomfort, upset, or pain
  • stuffy nose
  • tiredness
  • trouble concentrating
  • weight loss

For Healthcare Professionals

Applies to esmolol: intravenous solution


Very common (10% or more): Hypotension
Uncommon (0.1% to 1%): Bradycardia, atrioventricular block, pulmonary arterial pressure increased, cardiac failure, ventricular extrasystoles, nodal rhythm, angina pectoris, peripheral ischemia, pallor, flushing, chest pain, asystole
Rare (0.01% to 0.1%): Sinus pause
Very rare (less than 0.01%): Sinus arrest, asystole, thrombophlebitis
Frequency not reported: Accelerated idioventricular rhythm, coronary arteriospasm, cardiac arrest[Ref]


Very common (10% or more): Diaphoresis
Uncommon (0.1% to 1%): Skin discoloration, erythema
Very rare (less than 0.01%): Skin necrosis (due to extravasation)
Frequency not reported: Psoriasis, angioedema, urticaria[Ref]


Common (1% to 10%): Nausea, vomiting
Uncommon (0.1% to 1%): Dysgeusia, dyspepsia, constipation, dry mouth, abdominal pain[Ref]


Uncommon (0.1% to 1%): Urinary retention[Ref]


Common (1% to 10%): Injection site reaction, infusion site reaction, infusion site inflammation, infusion site induration
Uncommon (0.1% to 1%): Infusion site burning, infusion site ecchymosis
Frequency not reported: Infusion site phlebitis, infusion site vesicles, blistering[Ref]

Nervous system

Common (1% to 10%): Dizziness, somnolence, headache, paresthesia, weakness
Uncommon (0.1% to 1%): Syncope, convulsion, speech disorder, light headedness[Ref]


Frequency not reported: Hyperkalemia, metabolic acidosis[Ref]


Uncommon (0.1% to 1%): Musculoskeletal pain[Ref]


Uncommon (0.1% to 1%): Visual impairment[Ref]


Common (1% to 10%): Asthenia, fatigue
Uncommon (0.1% to 1%): Chills, pyrexia, edema, pain[Ref]


Common (1% to 10%): Depression, anxiety, disturbance in attention, confusion, agitation
Uncommon (less than 1%): Abnormal thinking[Ref]


Uncommon (less than 1%): Dyspnea, pulmonary edema, bronchospasm, wheezing, nasal congestion, rhonchi, rales[Ref]


1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

2. Cerner Multum, Inc. "Australian Product Information." O 0

3. "Product Information. Brevibloc (esmolol)." DuPont Pharmaceuticals, Wilmington, DE.

Not all side effects for esmolol may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.