icatibant


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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.
Drug Guide, © 2015 Farlex and Partners
References in periodicals archive ?
Icatibant, a competitive and selective antagonist of the bradykinin B2 receptor, was used by most of our patients to treat attacks.
The availability of appropriate drug therapies, such as C1-INH concentrate, or recombinant, icatibant or ecallantide, is paramount in reducing mortality and improving the quality of life of HAE patients [3, 4, 23].
Parameter Localization of angioedema, n, (%) (i) Head and neck 100 (95.2%) (ii) Peripheral 14 (13.3%) (iii) Abdominal 3 (2.9%) Concomitant rash, n, (%) 19 (18%) Treatment of acute attacks, n, (%) Antihistamines 96 (91.4%) Efficacy reported by 62.5% Corticosteroids 79 (75.2%) Efficacy reported by 63.3% Adrenaline 20 (19.0%) Efficacy reported by 15.0% Icatibant 3 (2.9%) Efficacy reported by 66.7% Tranexamic acid 1 (<1%) Efficacy reported by 0% Beta-2 agonists 1 (<1%) Unknown effect Montelukast 2 (1.9%) Unknown effect Azathioprine 1 (<1%) Unknown effect Airway management Intubation 4 patients 3.8% Tracheostomy 1 patient 0.9% Table 3: Data regarding hospital admissions and Emergency Department visits.
Icatibant for the treatment of hereditary angioedema.
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).
VIENNA -- The investigational bradykinin receptor antagonist icatibant appears to hold considerable therapeutic potential in episodes of hereditary angioedema, Konrad Bork, M.D., said at the annual meeting of the European Society for Dermatological Research.
Summary: As per the forecast of Fact.MR, the icatibant segment is expected to reach a value of nearly US$ 410 Mn in the year 2022.
Icatibant was used to treat 9.3% of patients (4/43) for life-threatening attacks.