Icatibant Fresenius Kabi Limited (Icatibant Acetate)

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

• Hereditary angioedema type I: rapid reduction of abdominal and peripheral swelling during acute attacks.
• Hereditary angioedema type II: fast relief of facial and airway edema in crisis situations.
• Hereditary angioedema with normal C1‑inhibitor: symptom control of sudden swelling episodes.

• Icatibant acetate selectively blocks the bradykinin B2 receptor on vascular endothelial cells, preventing bradykinin‑mediated vasodilation and increased vascular permeability. By inhibiting this receptor, the drug reduces the fluid extravasation that causes the swelling characteristic of hereditary angioedema attacks.

Icatibant is generally well tolerated, but adverse reactions can occur.

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 local 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.
• Hypotension: marked drop in blood pressure.
• Angioedema unrelated to HAE: unexpected swelling elsewhere.
• Urticaria: hives or skin rash.
• Thrombocytopenia: low platelet count observed in rare cases.

Before initiating therapy, clinicians should consider several safety measures.

• Confirm diagnosis: ensure the patient has hereditary angioedema with documented C1‑inhibitor deficiency.
• Assess hypersensitivity: avoid use in individuals with known allergy to icatibant or its excipients.
• Concomitant ACE inhibitors: use caution as combined bradykinin elevation may increase angioedema risk.
• Pregnancy and lactation: safety not established; prescribe only if benefits outweigh potential risks.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake the vial.

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

Major Interactions (Avoid)

• ACE inhibitors: additive bradykinin increase may precipitate angioedema.
• C1‑inhibitor concentrate: concurrent use is not recommended due to overlapping mechanisms.
• Other bradykinin B2 antagonists: combined effect may lead to excessive blockade.

Moderate Interactions (Monitor Closely)

• Estrogen‑containing contraceptives: may alter frequency of HAE attacks.
• Diuretics: monitor blood pressure for additive hypotensive effect.
• Beta‑blockers: may mask early signs of anaphylaxis or hypotension.