icatibant

(redirected from Firazyr)

icatibant

(eye-kat-i-bant) ,

Firazyr

(trade name)

Classification

Therapeutic: hereditary angioedema agents
Pharmacologic: bradykinin b2 receptor antagonists
Pregnancy Category: C

Indications

Treatment of attacks of hereditary angioedema (HAE) in patients >18 yr.

Action

Antagonizes the effects of bradykinin which are responsible for symptoms of HAE.

Therapeutic effects

Decreased manifestations of HAE including skin swelling, skin pain and abdominal pain with decreased progression to laryngeal edema.

Pharmacokinetics

Absorption: 97% absorbed following subcutaneous administration.
Distribution: Unknown.
Metabolism and Excretion: Metabolized systemically by proteolytic enzymes to metabolites that are renally excreted; <10% excreted unchanged in urine.
Half-life: 1.4 hr.

Time/action profile (reduction of symptoms)

ROUTEONSETPEAKDURATION
Subcutwithin 1 hr2.0–2.6 hr†6–8 hr
† 50% reduction in baseline symptoms.

Contraindications/Precautions

Contraindicated in: None noted.
Use Cautiously in: Obstetric: Use during pregnancy only if potential benefit justifies potential risk to fetus; Lactation: Use cautiously during lactation; Pediatric: Safe and effective use in patients <18 yr has not been established.

Adverse Reactions/Side Effects

Central nervous system

  • dizziness

Gastrointestinal

  • ↑ transaminases

Local

  • injection site reactions (most frequent)

Miscellaneous

  • fever

Interactions

Drug-Drug interaction

May ↓ antihypertensive response to ACE inhibitors.

Route/Dosage

Subcutaneous (Adults >18yr) 30 mg may be repeated in 6 hr, not to exceed 3 injections/24 hr.

Availability

Solution for subcutaneous injection: 10 mg/mL in 3 mL syringe (30 mg/syringe)

Nursing implications

Nursing assessment

  • Assess for symptoms of hereditary angioedema (submucosal or subcutaneous swelling) before and following treatment.
  • Lab Test Considerations: May cause ↑ serum transaminases.

Potential Nursing Diagnoses

Ineffective breathing pattern (Indications)

Implementation

  • Additional doses may be administered with at least 6 hrs between injection if response is inadequate or symptoms recur. Do not administer more that 3 doses in 24 hr.
  • Subcutaneous: Inject into abdominal area using the 25 gauge needle provided. Pinch fold of skin about 2–4 inches from belly button and inject at a 45°–90° angle. Avoid areas with scars or that are bruised, swollen, or painful. Do not use a different needle. Solution is clear and colorless; do not administer solutions that are discolored or contain particulate matter.

Patient/Family Teaching

  • Instruct patient in recognizing symptoms of hereditary angioedema and correct technique for self-administration and disposal of equipment.
  • Caution patient to seek medical attention immediately after injection if laryngeal swelling occurs.
  • May cause tiredness, drowsiness, and dizziness. Caution patient to avoid driving, and other activities requiring alertness until response to medication is known.
  • Advise patient to notify health care professional if fever, dizziness, or rash occur.
  • Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications.
  • Advise female patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

Evaluation/Desired Outcomes

  • Resolution of signs and symptoms of an acute attack of hereditary angioedema.
References in periodicals archive ?
* On September 21, 2018, Shire announced that the Ministry of Health, Labour and Welfare in Japan had granted manufacturing and marketing authorization for FIRAZYR, for the acute treatment of HAE attacks in adult patients with HAE.
* Momentum of key growth products in our 5 Key Business Areas is expected to largely offset the significant Loss of Exclusivity of VELCADE, FIRAZYR, ULORIC & other products.
Barbier has made significant contributions to several approved products such as Elaprase (Hunter syndrome), Aubagio (multiple sclerosis) and Firazyr (hereditary angioedema) and has led several investigational new drug applications for new chemical entities.
includes Firazyr (icatibant acetate), approved for treatment of acute
[3] Firazyr (Icatibant) Product Information, Shire Orphan Therapies, Inc., Lexington, MA, USA, 2013.
During her career, Barbier has made significant contributions to several approved products such as Elaprase (Hunter syndrome), Aubagio (multiple sclerosis) and Firazyr (hereditary angioedema), and has led several investigational new drug applications for new chemical entities.
M2 EQUITYBITES-October 26, 2017-EC approves label extension of Shire's FIRAZYR for symptomatic treatment of HAE attacks in paediatric patients
The new drug will complement Shire's own existing HAE treatments Firazyr and Cinryze.
An emergency treatment with the plasma-derived or recombinant C1-INH administered by intravenous infusion at a dose of 20 U/kg can induce an unusually dramatic regression of all symptoms in 30 to 60 minutes.8 Kallikrein inhibitor ecallantide (Kalbitor) and a bradykinin B2 receptor antagonist icatibant (Firazyr) are also approved for the treatment of acute episodes in recent years.
This C1 esterase inhibitor complements Shire's FIRAZYR icatibant injection for the treatment of acute HAE attacks.
In contrast, the animal data for icatibant (Firazyr; C), the other hematologic agent that is indicated for the treatment of acute attacks of hereditary angioedema, suggest risk.
This has led to the development of icatibant (Firazyr, Shire, North Ryde, NSW), a selective bradykinin receptor 2 antagonist that has shown promising results in the clinical setting (4).