A very short-acting beta-blocker drip for a fast heartbeat in hospital
Landiolol
A very short-acting beta-blocker drip used in hospital to quickly slow a fast heart rhythm, with an effect that wears off rapidly when it is stopped.
What is Landiolol?
Landiolol is a beta-blocker given as a drip into a vein in hospital to slow down a fast heart rhythm, such as a rapid heartbeat that can occur during or after surgery or in certain irregular rhythms. Its key feature is that it acts very quickly and wears off rapidly once the drip is stopped, which makes it easy to control. It can lower the blood pressure and slow the heart, so it is given with close monitoring of heart rate and blood pressure. It is a short-term hospital treatment rather than something taken at home.
Education and reference only. This is a plain-language guide to Landiolol — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Landiolol is a beta-blocker designed for use as a drip into a vein in hospital. Like other beta-blockers, it slows the heart and reduces how forcefully it beats, but it is unusual in being very short-acting: its effect comes on quickly and fades rapidly once the infusion is stopped. This makes it useful for controlling a fast heart rate in situations that can change quickly, such as during or after surgery, or in certain fast or irregular heart rhythms. It is given and managed entirely by the hospital team with close monitoring.
How it works
Landiolol blocks beta-receptors in the heart, the same receptors that adrenaline-like signals act on to speed the heart up. By blocking them, it slows the heart rate and eases how hard the heart works, helping to bring a fast rhythm under control. Because the body breaks it down very quickly, its effect lasts only a short time, so it is given as a continuous drip that can be turned up, down or off to fine-tune the heart rate from moment to moment. This rapid on-and-off action is its main advantage in fast-changing situations.
Company & origin
Originated / developed by: Specialist manufacturer.
A hospital medicine given into a vein in the UK to quickly slow a fast heart rhythm, with an effect that wears off rapidly when the drip is stopped.
Practical use
How to take Landiolol
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is given by the hospital team as a controlled drip into a vein, not something you take yourself.
- The rate is adjusted carefully to bring your heart rate to a safe level.
- You will have continuous monitoring of your heart rate and blood pressure during treatment.
- Tell the staff straight away if you feel faint, dizzy, breathless or unwell.
- Because it wears off quickly, the effect can be reduced rapidly by adjusting or stopping the drip.
Weighing it up
Advantages & disadvantages of Landiolol
Advantages
- Slows a fast heart rhythm quickly and can be fine-tuned moment to moment.
- Wears off rapidly once stopped, which makes it easy to control in unstable situations.
- Useful for fast heart rates during or after surgery and in certain irregular rhythms.
Disadvantages
- Can lower the blood pressure and slow the heart too much if not carefully adjusted.
- Only suitable as a short-term hospital treatment under close monitoring.
- Used with care in people with asthma or certain heart conditions, as beta-blockers can worsen these.
Practical use
Good to know
Landiolol's standout feature is how quickly it works and how quickly it wears off: this lets the hospital team fine-tune the heart rate moment to moment and stop the effect rapidly if needed, which is reassuring in unstable situations. The main things to watch for are a fall in blood pressure and a heart rate that becomes too slow, since these are the expected effects of a beta-blocker pushed too far, so heart rate and blood pressure are monitored continuously and the drip is adjusted accordingly. It is used with care in people with certain breathing conditions such as asthma, and in those with particular heart problems, because beta-blockers can worsen these. As it is given entirely by the hospital team into a vein, there is nothing to take at home; the patient's role is to report feeling faint, dizzy or breathless.
Who should not take it / use with caution
- It is avoided or used with great caution in people with a very slow heart rate or certain heart-rhythm or heart-failure problems.
- It is used with caution in people with asthma or other conditions that cause narrowing of the airways.
- People who have had a serious allergic reaction to it should not be given it.
Monitoring
- Continuous monitoring of heart rate and blood pressure throughout treatment.
- Watching the heart's rhythm (ECG) as the drip is adjusted.
- Watching for breathlessness in people prone to airway narrowing.
Side effects
- A fall in blood pressure, which may cause light-headedness.
- A heart rate that becomes too slow.
- Less commonly, breathlessness in people prone to airway narrowing, or injection-site reactions.
Key interactions
- Other medicines that slow the heart, such as some heart-rhythm drugs and calcium-channel blockers, can add to its effect.
- Medicines that lower blood pressure can combine with it to lower it further.
- The hospital team reviews all your medicines before and during treatment.
Available as: A solution given as a controlled infusion into a vein in hospital.
Answers
Landiolol: frequently asked questions
What is landiolol used for?
It is given in hospital to quickly slow a fast heart rhythm, such as a rapid heartbeat during or after surgery or in certain irregular rhythms.
Why is it described as short-acting?
Landiolol works very quickly and wears off rapidly once the drip is stopped, which lets the team fine-tune your heart rate and stop the effect quickly if needed.
How is it given?
It is given as a controlled drip into a vein by the hospital team, with continuous monitoring of your heart rate and blood pressure.
What are the main risks?
As a beta-blocker, it can lower the blood pressure and slow the heart too much, which is why heart rate and blood pressure are monitored closely and the drip is adjusted.
Can people with asthma have it?
It is used with caution in people with asthma or other conditions that narrow the airways, as beta-blockers can worsen these; the team weighs this up carefully.
The wider class
About Very short-acting intravenous beta-blocker
Landiolol belongs to the very short-acting intravenous beta-blocker class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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