Icatibant Cipla (Icatibant)

Icatibant is a targeted therapy for the bradykinin‑mediated pathway that underlies hereditary angioedema.

• Acute hereditary angioedema (C1‑inhibitor deficiency): rapidly reduces swelling and restores airway patency during an attack.
• Hereditary angioedema type I: provides symptom relief by blocking excess bradykinin.
• Hereditary angioedema type II: mitigates edema by antagonizing the B2 receptor.

• Icatibant acts as a competitive antagonist at the bradykinin B2 receptor on vascular endothelial cells. By blocking this receptor, it prevents bradykinin‑induced increases in vascular permeability, thereby reducing the formation of edema and the associated swelling characteristic of hereditary angioedema attacks.

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

Common Side Effects

• Injection site pain: mild to moderate discomfort at the injection site.
• Redness or erythema: localized skin reddening.
• Swelling at injection site: transient edema.
• Nausea: occasional gastrointestinal upset.
• Headache: mild to moderate intensity.
• Dizziness: transient light‑headedness.

Serious or Rare Side Effects

• Anaphylaxis: severe allergic reaction requiring immediate medical attention.
• Angioedema: paradoxical swelling in other body regions.
• Severe hypotension: marked drop in blood pressure.
• Urticaria: widespread hives.
• Thrombocytopenia: low platelet count.
• Severe injection site infection: signs of cellulitis or abscess.

Before using Icatibant, clinicians should consider several safety aspects to minimise risk.

• Contraindication: known hypersensitivity to icatibant or any excipients.
• Pregnancy: safety not established; use only if clearly needed.
• Breastfeeding: unknown; weigh benefits against potential risks.
• Renal or hepatic impairment: monitor closely as clearance may be affected.
• Concomitant bradykinin‑enhancing drugs: avoid or adjust therapy.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Icatibant can interact with other medicines that influence the bradykinin system or vascular tone.

Major Interactions (Avoid)

• ACE inhibitors: may increase bradykinin levels and exacerbate angioedema.
• Neprilysin inhibitors: elevate bradykinin, raising risk of severe swelling.
• Other bradykinin B2 antagonists: additive pharmacologic effect.

Moderate Interactions (Monitor Closely)

• Estrogen‑containing oral contraceptives: may modestly increase bradykinin activity.
• Hormone replacement therapy: similar potential effect.
• Diuretics: monitor blood pressure changes.
• Antihistamines: may mask early signs of allergic reactions.
• NSAIDs: watch for increased risk of edema.