Icatibant

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General

  • Type: Bradykinin receptor antagonist
  • Dosage Forms: 30mg
  • Routes of Administration: Subcutaneous
  • Common Trade Names: Firazyr

Adult Dosing

Hereditary angioedema

  • 30mg subcutaneous x 1
    • May repeat q6h if inadequate response/symptoms recur
  • Max 90mg/24 hours

Pediatric Dosing

not available (8/2015)

Special Populations

Contraindications

  • Allergy to class/drug

Adverse Reactions

Serious

  • Caution if acute MI
  • Caution if unstable angina
  • Caution if recent stroke

Common

  • Injection site reaction
  • Dizziness
  • Fever
  • Increased LFTs

Pharmacology

  • Half-life: 1.4h
  • Metabolism: Proteolytic degradation
  • Excretion: Urine 10% unchanged
  • Mechanism of Action: selectively antagonizes bradykinin B2 receptor

Comments

  • NEJM article 1/2015 randomized 27 people with ACEi induced angioedema to icatibant vs std therapy (Prednisone 500mg + Clemastine 2mg) looking at time to resolution.

RESULTS- significantly shorter (8 hrs vs 27.1 hrs) in icatibant group.

  • Cost according to Goodrx= $9,000/dose (on 8/7/2015)

See Also

References

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