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Landiolol

(Rapiblyk®)

Rapiblyk®

Drug updated on 3/28/2025

Dosage FormInjection (intravenous; 280 mg as a lyophilized powder in a single-dose)
Drug ClassBeta adrenergic blockers
Ongoing and
Completed Studies		ClinicalTrials.gov

Indication

  • Indicated for the short-term reduction of ventricular rate in adults with supraventricular tachycardia including atrial fibrillation and atrial flutter

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Summary
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  • This summary is based on the review of six systematic review(s)/meta-analysis(es). [1-6]
  • In adult patients with septic shock, esmolol was associated with a significant reduction in 28-day in-hospital mortality (Odds Ratio [OR]: 0.47), while landiolol showed no mortality benefit (OR: 0.98).
  • In patients undergoing cardiothoracic surgery, landiolol significantly reduced the incidence of postoperative atrial fibrillation (AF) (OR: 0.32; Relative Risk [RR]: 0.40) and shortened hospital length of stay by -2.32 days.
  • In critical care patients with new-onset atrial fibrillation, landiolol achieved heart rate control and conversion to sinus rhythm with an efficacy of 75.7% in non-surgical and 70.1% in surgical settings.
  • In the same patient population, hypotension occurred in 13%. Among patients with supraventricular tachyarrhythmia and left ventricular dysfunction, adverse events (primarily hypotension) occurred in 14.7% of those receiving landiolol, with no significant difference in adverse events compared to alternative antiarrhythmic drugs.
  • Among patients undergoing cardiothoracic surgery, no significant difference in bradycardia was observed with landiolol use (RR: 1.11), and no hypotension or increased risk of major postoperative complications was reported.
  • No significant differences in short-term mortality were observed in septic patients based on age (<65 vs. ≥65 years) or cardiac rhythm (sinus tachycardia vs. atrial fibrillation). Landiolol showed comparable efficacy in heart rate control and sinus rhythm conversion in both surgical (70.1%) and non-surgical (75.7%) critical care settings. Included populations were adult septic patients with persistent tachycardia, adults with septic shock, critical care patients with new-onset atrial fibrillation excluding cardiac surgery and medical cardiac care settings, patients with supraventricular tachyarrhythmia and left ventricular dysfunction, and those undergoing cardiothoracic surgeries including cardiac, lung cancer, and esophageal cancer procedures.