Icatibant Adalvo (Icatibant Acetate)

• Icatibant acts on the bradykinin pathway to manage hereditary angioedema episodes.
• Hereditary angioedema type I: rapid reduction of swelling during acute attacks.
• Hereditary angioedema type II: rapid reduction of swelling during acute attacks.
• Hereditary angioedema with normal C1‑inhibitor: rapid reduction of swelling during acute attacks.

• Icatibant competitively blocks the bradykinin B2 receptor, preventing bradykinin‑mediated vasodilation and increased vascular permeability. By inhibiting this receptor, the drug reduces the plasma leakage and tissue swelling that characterize hereditary angioedema attacks, leading to faster symptom resolution.

Icatibant may cause a range of adverse reactions, most of which are related to its subcutaneous administration and its pharmacologic activity.

Common Side Effects

• Injection site pain: mild to moderate discomfort at the injection site.
• Redness or swelling at injection site: localized erythema and edema.
• Headache: transient headache occurring after dosing.
• Nausea: occasional feeling of nausea without vomiting.
• Dizziness: light‑headed sensation shortly after injection.

Serious or Rare Side Effects

• Anaphylaxis: severe allergic reaction requiring immediate medical attention.
• Severe hypotension: marked drop in blood pressure, potentially leading to fainting.
• Angioedema unrelated to HAE: unexpected swelling of lips, tongue, or airway.
• Urticaria: widespread hives or skin rash.
• Thrombocytopenia: low platelet count observed in rare cases.

• Before using Icatibant, certain safety considerations should be observed.
• Pregnancy: consult a healthcare provider before use.
• Breastfeeding: caution advised; discuss risks with a clinician.
• Renal impairment: monitor renal function and adjust therapy if needed.
• Concomitant ACE inhibitors: increased risk of angioedema; assess benefit‑risk.
• Hypersensitivity: discontinue if signs of allergic reaction appear.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Icatibant may interact with other medicines that affect bradykinin pathways or hemodynamics.

Major Interactions (Avoid)

• ACE inhibitors: heightened risk of angioedema.
• DPP‑4 inhibitors: potential potentiation of bradykinin effects.
• Estrogen‑containing contraceptives: may exacerbate hereditary angioedema.

Moderate Interactions (Monitor Closely)

• NSAIDs: may increase incidence of headache.
• Antihistamines: could mask early signs of allergic reactions.
• C1‑esterase inhibitor concentrates: concurrent use generally unnecessary but monitor clinical response.