Brevibloc

Supraventricular tachycardia or noncompensatory sinus tachycardia (Step-wise dosing): Initial loading dose: 500mcg/kg infused over 1min followed by maintenance infusion of 50mcg/kg/min for the next 4mins; if needed, may continue maintenance infusion at 50mcg/kg/min or increase step-wise (eg, 100mcg/kg/min, 150mcg/kg/min, to max 200mcg/kg/min) with each step being maintained for 4mins. Effective maintenance dose (continuous or step-wise): 50–200mcg/kg/min (although, doses as low as 25mcg/kg/min have been adequate); infusions may be continued for up to 48hrs. Intraoperative and postoperative tachycardia and hypertension (Immediate control): 1mg/kg bolus dose over 30secs followed by 150mcg/kg/min infusion, if necessary; (Gradual control):  500mcg/kg bolus dose over 1min followed by 4-min maintenance infusion of 50mcg/kg/min. May adjust infusion rate as required up to max 200mcg/kg/min for tachycardia or max 300mcg/kg/min for hypertension. Once adequate control of HR and a stable clinical status is achieved, may transition to alternative antiarrhythmic drugs. Transition to alternative drug: reduce Brevibloc dose by ½ after 30mins following the first dose of the alternative drug; discontinue Brevibloc if satisfactory control is maintained for the first hour after administering the second dose of the alternative drug.