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a cardiac depressant used in treatment of atrial arrhythmias; administered by intravenous infusion as the fumarate salt.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.


(eye-byoo-ti-lide) ,


(trade name)


Therapeutic: antiarrhythmics
Pregnancy Category: C


Rapid conversion of recent-onset atrial flutter or fibrillation to normal sinus rhythm, including management of atrial flutter or fibrillation occurring within 1 wk of coronary artery bypass or cardiac valve surgery.


Activates slow inward current of sodium in cardiac tissue, resulting in delayed repolarization, prolonged action potential duration, and increased refractoriness.
Mildly slows sinus rate and AV conduction.

Therapeutic effects

Conversion to normal sinus rhythm.


Absorption: IV administration results in complete bioavailability.
Distribution: Unknown.
Metabolism and Excretion: Highly metabolized by the liver, one metabolite is active; metabolites excreted by kidneys.
Half-life: 6 hr (2–12 hr).

Time/action profile (antiarrhythmic effect)

IVwithin 30–90 minunknownup to 24 hr


Contraindicated in: Hypersensitivity.
Use Cautiously in: HF or left ventricular dysfunction (↑ risk of more serious arrhythmias during infusion); Obstetric / Lactation / Pediatric: Pregnancy, lactation, or children <18 yr (safety not established).

Adverse Reactions/Side Effects

Central nervous system

  • headache


  • arrhythmias (most frequent)


  • nausea


Drug-Drug interaction

Amiodarone, disopyramide, procainamide, quinidine, and sotalol should not be given concurrently or within 4 hr because of additive effects on refractoriness.Proarrhythmic effects may be ↑ by phenothiazines, tricyclic and tetracyclicantidepressants, some antihistamines, and histamine H2-receptor blocking agents ; concurrent use should be avoided.


Atrial Fibrillation/Flutter
Intravenous (Adults ≥60 kg) 1 mg infusion; may be repeated 10 min after end of first infusion.
Intravenous (Adults <60 kg) 0.01 mg/kg infusion; may be repeated 10 min after end of first infusion.
Atrial Fibrillation/Flutter After Cardiac Surgery
Intravenous (Adults ≥60 kg) 0.5 mg infusion, may be repeated once.
Intravenous (Adults <60 kg) 0.005 mg/kg infusion, may be repeated once.

Availability (generic available)

Solution for injection: 0.1 mg/mL

Nursing implications

Nursing assessment

  • Monitor ECG continuously throughout and for 4 hr after infusion or until QT interval normalizes. Discontinue if arrhythmia terminates or if sustained ventricular tachycardia, prolonged QT, or QT develops. Ibutilide may have proarrhythmic effects. These arrhythmias may be serious and potentially life threatening. Clinicians trained to treat ventricular arrhythmias, medications, and equipment (defibrillator/cardioverter) should be available during therapy and monitoring of patient.

Potential Nursing Diagnoses

Decreased cardiac output (Indications)


  • Oral antiarrhythmic therapy may be instituted 4 hr after ibutilide infusion.
  • Intravenous Administration
  • pH: 4.6.
  • Intermittent Infusion: Diluent: May be administered undiluted or diluted in 50 mL of 0.9% NaCl or D5W. Diluted solution is stable for 24 hr at room temperature or 48 hr if refrigerated.Concentration: Undiluted: 0.1 mg/mL; Diluted: 0.017 mg/mL.
  • Rate: Administer over 10 min.
  • Additive Incompatibility: Information unavailable; do not admix with other solutions or medications.

Patient/Family Teaching

  • Inform patient of the purpose of ibutilide.

Evaluation/Desired Outcomes

  • Conversion of recent-onset atrial flutter or fibrillation to normal sinus rhythm.
Drug Guide, © 2015 Farlex and Partners
References in periodicals archive ?
Lee, "Ibutilide, a new compound with potent class III antiarrhythmic activity, activates a slow inward Na+ current in guinea pig ventricular cells," The Journal of Pharmacology and Experimental Therapeutics, vol.
* IV procainamide or ibutilide are the agents of choice for AF with pre-excitation.
Intravenous vernakalant, which is recently included in the guidelines for rhythm control, is recommended as an alternative to ibutilide in patients who have congenital heart disease and newly diagnosed AF.
Other antiarrhythmic drugs such as propafenone, flecainide, or ibutilide can rarely be used in ICU patients with AF, because they are contraindicated in patients with structural heart disease due to a high risk of proarrhythmic side effects [8, 9].
Table 1--Causes of Long QT Syndrome Congenital Acquired Inherited Metabolic chairnelopathies Roman o-Ward Hypocalcernia, Syndrome hypokalemia, hypomagnesemia Jervell and Lange-Nielsen Syndrome Idiopathic Anti-Arrytbmics Amiodarone, Diospyramide, Dofetilide, ibutilide, Quinidine, Procainamide, Sotalol Antibistarnines Asteinizole, Terfenidine Anti-Infectives Clan thromycin, Erythrornycin, Pentamidine, Sparfi oxcin Anti-Malarial Chioroquine, Halofantrinc Psychotropics Chiorprornazine, Flaloperidol, Thioridazone, SSRIs Heart Disease Left ventricular hvpertrop hy, heart failure, invocardial isehemia Common presentations of LQTS include palpitations, presyncope, syncope, or cardiac arrest.
Ibutilide fumarate injection, 0.1 mg/ Bioniche Pharma USA
Common Herb-Drug Interactions Herb Drug or drug class Interaction Echinacea Amiodarone or ibutilide Increases QT interval Statins, fibrates, niacin Increases risk of hepatotoxic effects Garlic Aspirin, clopidogrel, Increases bleeding risk warfarin, or heparinoid drugs Ginkgo Antidiabetes drugs Increases hypoglycemia biloba Aspirin Increases bleeding Warfarin Inhibits PAF hemorrhage Ginseng Antidiabetes drugs Increases hypoglycemia Digoxin Interferes with digoxin assay, leading to falsely increased levels Warfarin Decreases effectiveness of warfarin St.
Three ionic mechanisms could lead to increased repolarization: (1) activation of delayed Na current can occur early in repolarization and has been implicated in ibutilide QT prolongation [3]; (2) increase in inward [Ca.sup.2+] current; (3) most drug-induced QT prolongation is due to a reduction in or blockade of the rapid delayed rectifier current ([I.sub.Kr]) resulting in prolonged cardiac repolarization [4].
The newer antiarrhythmics like dofetilide and ibutilide are more potent as well as highly selective for [K.sub.v] channels (Table IV).
Drugs that triggered Torsades de Pointes Antibiotic agents Anti-arrhythmics Psychotropic agents Erythromycin (n=4) Sotalol (n=3) Amitryptiline (n=1) Roxithromycin (n=2) Ibutilide (n=1) Haloperidol (n=1) Gatifloxacin (n=2) Quinidine (n=1) Fluoxetine (n=1) Clarithromycin (n=1) Amiodarone (n=1) Risperidone (n=1) Levofloxacin (n=1) Antibiotic agents Anti-histamines Erythromycin (n=4) Astemisol (n=2) Roxithromycin (n=2) Terfanidine (n=1) Gatifloxacin (n=2) Clarithromycin (n=1) Levofloxacin (n=1)
With a few hundred patients treated so far, conversion of atrial fibrillation using RSD1235 has not led to any cases of torsades de pointes, which makes the drug more attractive than ibutilide, the only drug with Food and Drug Administration approval for conversion of atrial fibrillation, said Dr.