icatibant acetate: clinical use

Prescribing considerations

• Initiation and caregiver or self-administration decisions should be made by a clinician experienced in hereditary angioedema.
• Ensure injection training, an individual emergency plan and access to urgent care for airway attacks.
• Exercise caution in acute ischaemic heart disease, unstable angina and during the weeks following a stroke.
• Clinical experience is limited in older people and with repeated treatment of paediatric attacks.

Contraindications and cautions

• Hypersensitivity to icatibant or any excipient.

Monitoring

• Assess symptom response and recurrence after administration.
• Observe laryngeal attacks in an appropriate medical institution until discharge is considered safe.
• Review injection-site reactions and possible medicine-related adverse effects.
• No medicine-specific routine laboratory monitoring requirement is stated in the selected product information.

Clinical pharmacology

Icatibant is a synthetic peptide and selective competitive bradykinin B2-receptor antagonist. It is rapidly absorbed after subcutaneous administration, metabolised by proteolytic enzymes to inactive metabolites and is not expected to inhibit or induce major cytochrome P450 enzymes.

Formulation and product differences

• Clear, colourless solution in a single-use pre-filled glass syringe with a separate needle.
• Where a smaller paediatric volume is prescribed, an adapter and graduated syringe are required for preparation by a trained caregiver or healthcare professional.
• Store below the maximum temperature stated in the product information and do not freeze.

Injection

Route: Parenteral

Strengths: 30 mg