Icatibant Hikma (Icatibant)

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

• Hereditary angioedema type I: reduces swelling during acute attacks.
• Hereditary angioedema type II: alleviates symptoms of acute episodes.
• Acute hereditary angioedema attacks: provides rapid symptom control.

• Icatibant selectively blocks the bradykinin B2 receptor, preventing bradykinin from binding and triggering vasodilation and increased vascular permeability. By inhibiting this receptor, the drug curtails the cascade that leads to the rapid formation of edema in hereditary angioedema, thereby limiting swelling and associated discomfort.

Common Side Effects

• Injection site pain: mild to moderate discomfort at the injection site.
• Erythema: localized redness around the injection area.
• Nausea: occasional feeling of queasiness.
• Headache: transient mild to moderate headache.
• Dizziness: brief episodes of light‑headedness.
• Flushing: temporary warmth and reddening of the skin.

Serious or Rare Side Effects

• Anaphylaxis: severe allergic reaction requiring immediate medical attention.
• Angioedema: swelling of face, lips, or throat despite treatment.
• Hypotension: sudden drop in blood pressure.
• Severe allergic reaction: rash, bronchospasm, or swelling.
• Thrombocytopenia: low platelet count observed in rare cases.

Before initiating therapy, clinicians should consider patient‑specific factors and monitor for adverse events.

• Assess patient history: verify diagnosis of HAE type I or II before use.
• Monitor for hypersensitivity: observe for signs of allergic reaction after injection.
• Avoid use in patients with known hypersensitivity to icatibant or formulation components.
• Use with caution in pregnant or breastfeeding women: limited data, weigh benefits and risks.
• Renal or hepatic impairment: no dosage adjustment known, monitor clinical response.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Icatibant may interact with other agents that influence bradykinin pathways or immune responses.

Major Interactions (Avoid)

• ACE inhibitors: may increase bradykinin levels, raising risk of angioedema.
• Angiotensin receptor blockers: similar risk of enhanced bradykinin activity.
• Other bradykinin B2 antagonists: additive pharmacologic effect, avoid concurrent use.

Moderate Interactions (Monitor Closely)

• Corticosteroids: may mask signs of infection, monitor patient closely.
• Antihistamines: could alter assessment of allergic reactions, observe for changes.
• NSAIDs: may exacerbate gastrointestinal irritation, watch for adverse GI events.