Two medicines, side by side
Esmolol vs propranolol
Esmolol and propranolol are both labeled for high blood pressure and atrial fibrillation. Drugs@FDA records approvals of esmolol since 1986 and of propranolol since 1967. How each works, in its label's words: Esmolol, “BREVIBLOC (Esmolol Hydrochloride) injection is a beta 1 -selective (cardioselective) adrenergic receptor blocking agent with rapid onset, a very short duration of action, and no significant intrinsic …”; Propranolol, “Mechanism of Action The mechanism of the antihypertensive effect of propranolol has not been established.”
Check it at the source: the esmolol FDA label on DailyMed (effective March 14, 2025); the propranolol FDA label on DailyMed (effective January 15, 2026).
Highlights of the esmolol record
Esmolol (Brevibloc) · label of March 14, 2025
Used for
From the label: indicationsBREVIBLOC injection is a beta adrenergic blocker indicated for the short-term treatment of: • Control of ventricular rate in supraventricular tachycardia including atrial fibrillation and atrial flutter and control of heart rate in noncompensatory sinus tachycardia ( 1.1 ) • Control of perioperative tachycardia and hypertension ( 1.2 ) 1.1 Supraventricular Tachycardia or Noncompensatory Sinus Tachycardia BREVIBLOC […]
On the market
- Earliest approval on file
- December 31, 1986
- Generic labelers
- 12 labelers
- Pharmacy cost
- Not in the survey
Supply and safety
- Shortage
- No current entry
- Recalls
- 3
Highlights of the propranolol record
Propranolol (Inderal) · label of January 15, 2026
Used for
From the label: indicationsHypertension Propranolol hydrochloride tablets are indicated in the management of hypertension. It may be used alone or used in combination with other antihypertensive agents, particularly a thiazide diuretic. Propranolol hydrochloride tablets are not indicated in the management of hypertensive emergencies. […]
On the market
- Earliest approval on file
- November 13, 1967
- Generic labelers
- 42 labelers
- Pharmacy cost
- $0.0493 per tablet
Supply and safety
- Shortage
- In shortage
- Recalls
- 4
Source: FDA drug labels via openFDA (Esmolol label of March 14, 2025, Propranolol label of January 15, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do esmolol and propranolol differ on the record?
How each works, in its label's words: Esmolol, “BREVIBLOC (Esmolol Hydrochloride) injection is a beta 1 -selective (cardioselective) adrenergic receptor blocking agent with rapid onset, a very short duration of action, and no significant intrinsic …”; Propranolol, “Mechanism of Action The mechanism of the antihypertensive effect of propranolol has not been established.”
Both are in FDA's class beta-adrenergic blockers.
Half-life, in each label's words: Esmolol, “Its elimination half-life after intravenous infusion is approximately 9 minutes.”; Propranolol, “The plasma half-life of propranolol is from 3 to 6 hours.”
Generics: esmolol since 2004; propranolol since 1985 (Drugs@FDA).
| Esmolol | Propranolol | |
|---|---|---|
| Labeled for | High blood pressure, Atrial fibrillation | High blood pressure, Angina, Atrial fibrillation, Migraine |
| Pharmacologic class | beta-Adrenergic Blocker | beta-Adrenergic Blocker |
| How it works (label) | BREVIBLOC (Esmolol Hydrochloride) injection is a beta 1 -selective (cardioselective) adrenergic receptor blocking agent with rapid onset, a very short duration of action, and no significant intrinsic sympathomimetic or membrane stabilizing … | Mechanism of Action The mechanism of the antihypertensive effect of propranolol has not been established. |
| Half-life (label) | Its elimination half-life after intravenous infusion is approximately 9 minutes. | The plasma half-life of propranolol is from 3 to 6 hours. |
| Earliest approval on file (Drugs@FDA) | December 31, 1986 | November 13, 1967 |
| First generic approved | August 10, 2004 | July 30, 1985 |
| Generic labelers (NDC) | 12 labelers | 42 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | n/a | $0.0493 per tablet (Propranolol 20 mg tablet) |
| 12-month price change | n/a | -17% |
| Boxed warning | No | No |
| Shortage now | No current entry | In shortage |
| Recalls recorded | 3 | 4 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 265 | 71,660 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to esmolol
- every medicine labeled for the same conditions