Icatibant Glenmark Pharmaceuticals Europe (Icatibant Acetate)

Icatibant is a bradykinin B2 receptor antagonist used in the management of hereditary angioedema.

• Hereditary angioedema type I: reduces swelling and pain during acute attacks.
• Hereditary angioedema type II: blocks bradykinin‑mediated edema to control episodes.
• Hereditary angioedema attacks (C1‑inhibitor deficiency): provides rapid relief of symptoms.

• Icatibant acetate acts as a competitive antagonist at the bradykinin B2 receptor. By binding to this receptor, it prevents bradykinin from inducing vasodilation and increasing vascular permeability, thereby limiting the fluid extravasation and swelling that characterize hereditary angioedema attacks.

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

Common Side Effects

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

Serious or Rare Side Effects

• Anaphylaxis: severe allergic reaction requiring immediate medical care.
• Angioedema: unexpected swelling of face, lips, or throat.
• Hypotension: significant drop in blood pressure.
• Severe injection‑site reactions: necrosis or ulceration.
• Urticaria: widespread hives.
• Thrombocytopenia: low platelet count observed rarely.

Before initiating therapy, clinicians should evaluate patient history and monitor for potential adverse events.

• Assess patient history: confirm hereditary angioedema diagnosis prior to use.
• Monitor for hypersensitivity: watch for signs of allergic reaction during and after injection.
• Avoid in known hypersensitivity: do not use if the patient is allergic to icatibant or excipients.
• Use with caution in pregnancy or breastfeeding: safety not established, weigh benefits against risks.
• Renal or hepatic impairment: no dosage adjustment required but monitor clinical response.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Icatibant may interact with other medications that influence bradykinin pathways or cardiovascular function.

Major Interactions (Avoid)

• ACE inhibitors: may increase bradykinin levels, potentially reducing icatibant efficacy.
• Angiotensin receptor blockers: similar risk of altered bradykinin activity.
• Other bradykinin B2 antagonists: additive effects not studied.

Moderate Interactions (Monitor Closely)

• Estrogen‑containing contraceptives: may affect frequency of HAE attacks.
• Concurrent injectable biologics: monitor for overlapping injection‑site reactions.
• Diuretics: observe blood pressure for possible hypotensive episodes.