Icatibant Fresenius (Icatibant Acetate)

Icatibant is a competitive antagonist of the bradykinin B2 receptor. By blocking this receptor, it prevents bradykinin‑induced vasodilation and increased vascular permeability, which are key drivers of the swelling seen in hereditary angioedema.

The prescribed dose of icatibant is determined by the treating physician based on the patient’s clinical condition. Typically, a single subcutaneous injection is administered at the onset of an HAE attack, with additional doses given only if medically required.

Safety data for icatibant during pregnancy and lactation are limited. It is classified as pregnancy category unknown, so it should only be used when the potential benefit justifies the potential risk to the fetus or infant.

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The primary alternative for HAE attacks is plasma‑derived or recombinant C1‑inhibitor concentrate. While C1‑inhibitor replaces the deficient protein, icatibant directly blocks the bradykinin B2 receptor. Icatibant offers a rapid, subcutaneous option without the need for intravenous infusion, but C1‑inhibitor may be preferred in patients with contraindications to bradykinin blockade.

Icatibant should be stored refrigerated at 2‑8 °C. Keep the vial in its original packaging, protect it from light, and do not freeze or shake the solution. If temporary storage at room temperature is unavoidable, limit exposure to no more than 30 °C for a short period.

Icatibant is administered as a single subcutaneous injection, usually into the abdomen or thigh. The injection site should be cleaned with an alcohol swab, and the needle inserted at a 45‑ to 90‑degree angle. Patients or caregivers can be trained to perform the injection at the onset of an HAE attack.

Serious risks include severe hypersensitivity reactions such as anaphylaxis, airway‑compromising angioedema, and profound hypotension. Patients should be instructed to seek immediate medical attention if they experience difficulty breathing, swelling of the throat, or a sudden drop in blood pressure after injection.

Icatibant is contraindicated in individuals with known hypersensitivity to icatibant acetate or any of its excipients. Caution is also advised for patients with a history of severe allergic reactions, uncontrolled cardiovascular disease, or those who are pregnant or breastfeeding without a clear benefit.