Landiolol hydrochloride

How it works

It is a highly beta-1-selective adrenoceptor antagonist with a very short half-life that reduces heart rate and slows atrioventricular conduction, allowing rapid, titratable control of ventricular rate.

Prescribing in practice

• It is given by intravenous infusion under continuous cardiac and blood-pressure monitoring and is contraindicated in severe hypotension, decompensated heart failure, severe bradycardia and high-degree heart block without pacing.
• Its very short duration of action allows rapid titration, but hypotension and bradycardia can develop quickly and require prompt dose adjustment.
• Use with caution in patients with bronchospastic disease and in those receiving other rate-limiting or negatively inotropic drugs.

Monitoring

Administer with continuous ECG and blood-pressure monitoring, titrating to heart rate and watching closely for bradycardia and hypotension.

Counselling the patient

• Explain that this is a short-acting drip used to bring a fast heart rate under control.
• Its effects wear off quickly once the infusion is reduced or stopped.
• Heart rate and blood pressure are watched continuously during treatment.

Evidence & guidelines

Landiolol provides rapid, titratable heart-rate control in supraventricular tachyarrhythmias and is recognised in current prescribing references for short-term perioperative and critical-care use.