Icatibant Ethypharm (Icatibant)

Icatibant acts on the bradykinin pathway to control swelling in hereditary angioedema.

• Hereditary angioedema (C1‑inhibitor deficiency): provides rapid relief of acute swelling episodes and reduces the risk of airway obstruction.
• Hereditary angioedema (acquired): may be used under specialist supervision to manage acute attacks.
• Hereditary angioedema (type I/II): helps control symptoms when on‑demand therapy is required.

• Icatibant is a competitive antagonist of the bradykinin B2 receptor. By binding to this receptor, it blocks the actions of bradykinin, a peptide that causes vasodilation and increased vascular permeability. The inhibition prevents the cascade that leads to fluid extravasation and tissue swelling, thereby mitigating the acute manifestations of hereditary angioedema.

Icatibant may cause a range of adverse reactions following subcutaneous injection.

Common Side Effects

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

Serious or Rare Side Effects

• Anaphylaxis: severe allergic reaction requiring immediate medical attention.
• Severe hypotension: sudden drop in blood pressure.
• Angioedema unrelated to HAE: unexpected swelling in other body parts.
• Urticaria: widespread hives.
• Severe allergic reaction: includes bronchospasm or throat tightening.
• Thrombocytopenia: low platelet count observed in rare cases.

Before initiating therapy, clinicians should assess patient history and monitor for potential risks.

• Assess C1‑inhibitor status: confirm deficiency before use.
• Monitor for hypersensitivity: observe for signs of allergic reaction after each dose.
• Avoid in known hypersensitivity: do not administer to patients with documented icatibant allergy.
• Use with caution in pregnancy or breastfeeding: safety data are limited, weigh benefits against potential risks.
• Evaluate renal and hepatic function: adjust monitoring if organ impairment is present.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Icatibant may interact with other agents that influence the bradykinin system or cause additive effects.

Major Interactions (Avoid)

• ACE inhibitors: increased bradykinin levels may reduce icatibant efficacy and raise risk of angioedema.
• Angiotensin‑converting enzyme‑derived peptides: concurrent use may potentiate swelling.

Moderate Interactions (Monitor Closely)

• Estrogen‑containing contraceptives: may increase frequency of HAE attacks.
• DPP‑4 inhibitors: theoretical increase in bradykinin activity.
• Other B2 receptor antagonists: additive pharmacodynamic effects.
• Immunosuppressants: monitor for altered infection risk.