Rapiblyk
Generic name: landiolol
Dosage form: injection, for intravenous use
What is Rapiblyk?
Rapiblyk (landiolol) is a short-term treatment for supraventricular tachycardia including atrial fibrillation and atrial flutter to reduce the ventricular rate. Rapiblyk is a short-acting beta-adrenergic blocker that helps decrease heart rate (negative chronotropic effect) with less lowering of blood pressure. It is given as an intravenous infusion in a monitored setting.
Rapiblyk mechanism of action is a selective beta-1-adrenoreceptor antagonist. By blocking beta-1-receptors that are mainly in the heart, Rapiblyk helps to stop epinephrine and norepinephrine being able to speed up the heart rate, which results in a slower heart rate.
Rapiblyk FDA approval was granted on November 22, 2024, after positive results from clinical trials.
Rapiblyk side effects
The most common Rapiblyk side effect is lower blood pressure or hypotension (9.9%) compared to 1% of placebo patients in when studies in 19 placebo-controlled clinical trials.
Also, see the Warning and precaution section.
This may not be all of the possible side effects of this medicine. You may report side effects to the FDA at 1-800-FDA-1088.
Warnings and precautions
Risk of Low Blood Pressure, Slow Heart Rate, and Heart Failure: You will be watched and monitored for signs and symptoms of cardiovascular adverse effects. The dose may be reduced or the medication stopped.
Risk of Worsening Breathing Problems: Be cautious in patients with reactive airway diseases as patients with reactive airway disease should, in general, not receive beta-blockers. As Rapiblyk is relatively beta1 selective the injection may be titrated to the lowest possible effective dose. If bronchospasm occurs, stop the infusion immediately and a beta-2 stimulating agent may be administered with appropriate monitoring of ventricular rates.
Diabetes and hypoglycemia: This medication may hide signs of low blood sugar and affect blood sugar levels. Monitor closely.
Abrupt Discontinuation of Injection: Abruptly stopping beta-blocker therapy may cause severe exacerbations of angina, myocardial infarction, and ventricular arrhythmias in patients with coronary artery disease. Patients should be observed for signs of myocardial ischemia when discontinuing injection.
Who should not take Rapiblyk ?
Rapiblyk should not be used in patients with:
- Severe sinus bradycardia, sick sinus syndrome or heart block greater than first-degree
- Decompensated heart failure
- Cardiogenic shock as it may cause further cardiovascular collapse and cause cardiac arrest
- Pulmonary hypertension as it may cause cardiorespiratory decompensation.
- Known hypersensitivity to landiolol or any of the inactive ingredients.
Before taking this medicine
Before using this medicine tell your healthcare provider if you have:
- liver impairment
- are pregnant, or planning a pregnancy
- are breastfeeding or planning to breastfeed.
How will I receive Rapiblyk?
Rapiblyk is given as an intravenous infusion by your healthcare provider in a monitored setting.
Rapiblyk dosing information
Rapiblyk is administered as a continuous intravenous infusion, titrating as needed for heart rate control. There is limited data beyond 24 hours of use.
| Normal cardiac function | Impaired cardiac function | |
| Starting dose | 9 mcg/kg/min | 1 mcg/kg/min |
| Titration interval | 10 min | 15 min |
| Titration step | 9 mcg/kg/min | 1 mcg/kg/min |
| Maximum dose | 36 mcg/kg/min | 36 mcg/kg/min |
9 mcg/kg/min landiolol is equivalent to 9.6 mcg/kg/min landiolol hydrochloride
Rapiblyk is available as a single-dose vial containing 280 mg of landiolol (equivalent to 300 mg landiolol HCl), which is reconstituted with 50 mL of 0.9% Sodium Chloride Injection, USP or 5% Dextrose Injection, USP. Gently swirl to dissolve contents.
Related/similar drugs
amiodarone, diltiazem, bisoprolol, flecainide, phenylephrine, Adenocard
What other drugs will affect Rapiblyk?
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Some medicines may affect how Rapiblyk works, and it may affect how some medicines work. Especially tell your healthcare provider if you take:
Negative Inotropes and Chronotropes: Avoid using this medicine with negative inotropes and medications that slow heart rate or cardiac conduction.
Beta-blockers, like this medicine, can cause depression of myocardial contractility and increase the risk of slow heart rate (bradycardia) or heart block. Using Rapiblyk with negative inotropes or chronotropes may cause additive effects.
Sympathomimetics, Positive Inotropes, and Vasoconstrictors: Beta-adrenergic agonists will antagonize the effects of Rapiblyk and may attenuate its heart rate-lowering effects. Positive inotropes and vasoconstrictors may attenuate the heart rate and blood pressure-lowering effects of Rapiblyk.
Catecholamine Depleting Medicines Observe patients when using Rapiblyk with a catecholamine depletor (e.g., reserpine, monoamine oxidase inhibitors) for hypotension or marked bradycardia, which may cause vertigo, syncope, or postural hypotension.
Catecholamine-depleting drugs may have an additive effect when given with beta-blockers, which may increase the risk of hypotension or marked bradycardia-related vertigo, syncope, or postural hypotension.
This list of interactions is not complete. Many other drugs may interact with this medicine, and not all possible interactions are listed in this document.
Storage
Store unreconstituted vials at 20°C to 25°C (68ºF to 77ºF) with excursions permitted to 15ºC to 30ºC (59ºF to 86ºF).
Ingredients
Active ingredients landiolol
Inactive ingredients mannitol and sodium hydroxide to adjust pH.
Company
Rapiblyk AOP Orphan Pharmaceuticals GmbH Leopold-Ungar-Platz 2 1190 Vienna Austria.
More about Rapiblyk (landiolol)
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Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.