Landiolol (Rapiblyk), A Newly Approved, Ultra-Short Acting Intravenous β1-Adrenoreceptor Blocker for the Treatment of Supraventricular Arrhythmias.

Abstract

In 2025, the Food and Drug Administration approved landiolol (Rapiblyk), an intravenous β1-adrenoreceptor blocker for the rapid and short-term reduction of the ventricular rate in adult patients with supraventricular tachycardia, which includes those patients with atrial fibrillation and flutter. Other intravenous β-blockers approved for the same indication include esmolol (Brevibloc) and generics, and propranolol generics. Intravenous metoprolol (generic) is used off-label. Other rate-reducing treatments include intravenous nondihydropyridine calcium channel blockers such as diltiazem and verapamil. Etripamil is also being evaluated as a parenteral intranasal formulation for arrhythmia management. The clinical effectiveness, pharmacokinetic properties, and side effect profile of landiolol are reviewed in this article. At this juncture, the effectiveness of the drug in reducing the heart rate in patients with supraventricular arrhythmias, including atrial fibrillation and flutter, has been demonstrated to be as effective as generic β-blockers and calcium channel blockers.