landiolol

Landiolol, sold under the brand names Onoact, Rapibloc®, Sibboran® and Rapiblyk® among others, is a medication used for the treatment of supraventricular tachycardia, atrial fibrillation, and atrial flutter in perioperative, postoperative or other circumstances where short-term control of the ventricular rate with a short-acting agent is desirable. With the exception of the USA, landiolol is also indicated for non-compensatory sinus tachycardia where, in the physician's judgment, the rapid heart rate requires specific intervention. It is a β-adrenergic blocker; an ultra short-acting, β1-super-selective intravenous adrenergic antagonist [28], which decreases the heart rate effectively with fewer negative effects on blood pressure or myocardial contractility.[6][7] In comparison to other β blockers, landiolol has the shortest elimination half-life (3 to 4 minutes), ultra-rapid onset of effect (heart rate begins to decrease immediately after completion of administration), and predictable effectiveness with inactive metabolites (heart rate returns to baseline levels at 30 min after completion of landiolol hydrochloride administration).[8] The pure S-enantiomerstructure of landiolol is believed to develop less hypotensive side effects in comparison to other β-blockers. This has a positive impact on the treatment of patients when reduction of heart rate without decrease in arterial blood pressure is desired.[9] It is used as landiolol hydrochloride.

Landiolol was approved for medical use in Japan in 2002, [10][11], Europe in 2016, Canada in November 2023, it has been approved in Bahrain, Kuwait, Qatar and Oman since October 2024, in the United States in November 2024 [12] and in Australia in June 2025. [29]