Icatibant

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

• Pregnancy Rating: C
• Lactation risk: safety unknown
• Renal Dosing
• Hepatic Dosing

Contraindications

• Allergy to class/drug

Adverse Reactions

Serious

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

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

• Angioedema (Upper Airway)

References

Authors

Kurt Hansen, Ross Donaldson, Daniel Ostermayer