Esmolol

Date: July 2024, Version 4

Quick read

Esmolol can be used in pregnancy if recommended by a doctor.

What is it?

Esmolol is given over a short period to quickly correct a fast heartbeat, or a problem with the heart rhythm. It might also be used to reduce high blood pressure after an operation.

Benefits

What are the benefits of taking esmolol in pregnancy?

Esmolol reduces the risk of harm to both you and your baby from problems with the heart rate or rhythm, or high blood pressure after surgery.

Risks

Are there any risks of taking esmolol during pregnancy?

Esmolol belongs to a large family of medicines called beta blockers. There are no concerns that beta blockers cause birth defects, stillbirth or preterm birth.

Women taking beta blockers long-term are more likely to have a smaller baby. This is probably because the underlying health conditions that beta blockers are used to treat affect the baby’s growth, but some studies show that beta blockers add to this effect.

Esmolol used for a short period is unlikely to affect a baby’s growth. However, women who have been given esmolol may then be advised to take a different beta blocker long-term, which might affect the rate at which the baby gains weight in the womb.

Occasionally, beta blockers used in late pregnancy can affect your baby for a short while after birth (for example, causing low blood sugar). If esmolol or another beta blocker was given around the time of delivery, your baby may require an extra day or two in hospital following birth to look out for any problems. If these occur, they can be treated and usually settle quickly.

Alternatives

Are there any alternatives to taking esmolol?

Possibly. There may be other medicines that can be used instead. However, if a doctor advises you to use esmolol in pregnancy, they will explain why they think it is the most suitable medicine to treat your condition.

No treatment

What if I prefer not to take medicines to treat heart problems or high blood pressure?

It is very important to take any medicines prescribed for these conditions as they can be dangerous to both mother and baby and must be as well-controlled as possible.

Your doctor will only prescribe medicines when absolutely necessary and will be happy to talk to you about any concerns that you might have.

Will my baby need extra monitoring?

You will be offered a detailed scan at around 20 weeks of pregnancy as part of your routine antenatal care. No further monitoring of your baby is required due to esmolol use.

Are there any risks to my baby if the father has taken esmolol?

We would not expect any increased risk to your baby if the father takes esmolol.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet, please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system (MyBump Portal) allows women who are currently pregnant to create a secure record of their pregnancy, collected through a series of questionnaires. You will be asked to enter information about your health, whether or not you take any medicines, your pregnancy outcome and your child's development. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit the MyBump Portal to register.

General information
Sadly, miscarriage and birth defects can occur in any pregnancy.

Miscarriage occurs in about 1 in every 5 pregnancies, and 1 in every 40 babies are born with a birth defect. This is called the ‘background risk’ and happens whether medication is taken or not.

Most medicines cross the placenta and reach the baby. For many medications this is not a problem. However, some medicines can affect a baby’s growth and development.

If you take regular medication and are planning to conceive, you should discuss whether your medicine is safe to continue with your doctor/health care team before becoming pregnant. If you have an unplanned pregnancy while taking a medicine, you should tell your doctor as soon as possible.

If a new medicine is suggested for you during pregnancy, please make sure that the person prescribing it knows that you are pregnant. If you have any concerns about a medicine, you can check with your doctor, midwife or pharmacist.

Our Bumps information leaflets provide information about the effects of medicines in pregnancy so that you can decide, together with your healthcare provider, what is best for you and your baby.