Landiolol in Acute Care Settings

Landiolol is a new ultra-short-acting beta-blocker for use in acute care settings. It is approved for the management of supraventricular tachycardia and for the rapid control of ventricular rate in atrial fibrillation or atrial flutter when short‑term rate control is required. It is also indicated for non‑compensatory sinus tachycardia when specific intervention is needed.

Landiolol is highly selective for β₁ adrenoceptors with very low affinity for β₂ receptors. This high degree of cardioselectivity minimises the impact on blood pressure and reduces the risk of bronchospasm compared with less selective beta-blockers. Landiolol has a very short half-life (~4 minutes) which supports precise dose titration and enables rapid recovery once the infusion is reduced or discontinued.

Hypotension is the most commonly observed adverse effect. This typically resolves quickly with fluid administration, dose reduction, or discontinuation. Continuous blood pressure and ECG monitoring are recommended for all patients receiving landiolol.

Vials contain 300mg landiolol hydrochloride (equivalent to 280mg landiolol). Dosing is based on the salt rather than the free base.