Icatibant (Icatibant Acetate)

Icatibant acts on the bradykinin pathway to control hereditary angioedema episodes.

• Hereditary angioedema (C1‑inhibitor deficiency): rapidly reduces swelling during acute attacks.
• Hereditary angioedema type I: provides prompt symptom relief.
• Hereditary angioedema type II: blocks bradykinin‑mediated edema.
• Acute angioedema not responding to C1‑inhibitor therapy: offers an alternative mechanism of action.

• Icatibant is a selective antagonist of the bradykinin B2 receptor. By binding to this receptor, it blocks the actions of bradykinin, preventing the vasodilation and increased vascular permeability that lead to the swelling characteristic of hereditary angioedema attacks.

Icatibant may cause a range of adverse reactions, most of which are related to the injection site or systemic exposure.

Common Side Effects

• Injection site pain: discomfort at the subcutaneous injection site.
• Injection site erythema: redness around the injection area.
• Injection site swelling: localized edema.
• Nausea: feeling of stomach upset.
• Headache: mild to moderate head pain.
• Dizziness: transient sense of light‑headedness.

Serious or Rare Side Effects

• Anaphylaxis: severe allergic reaction requiring immediate medical attention.
• Severe hypotension: marked drop in blood pressure.
• Angioedema of the face or airway: swelling that can compromise breathing.
• Urticaria: widespread hives.
• Infection at injection site: signs of local infection.
• Thrombocytopenia: low platelet count observed in rare cases.

Before using icatibant, several safety considerations should be observed.

• Confirm diagnosis: verify hereditary angioedema with C1‑inhibitor deficiency.
• Assess hypersensitivity: monitor for allergic reactions to icatibant or excipients.
• Administer under supervision: ensure trained healthcare personnel give the subcutaneous injection.
• Avoid in known hypersensitivity: do not use if the patient has a documented allergy to icatibant.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Icatibant can interact with other medicines that affect the bradykinin system or blood pressure.

Major Interactions (Avoid)

• ACE inhibitors: may increase bradykinin levels and raise the risk of angioedema.
• Angiotensin receptor blockers: similar potential to elevate bradykinin‑related swelling.
• Other bradykinin B2 antagonists: additive pharmacologic effect may be unsafe.

Moderate Interactions (Monitor Closely)

• Estrogen‑containing contraceptives: may influence hereditary angioedema severity.
• C1‑inhibitor concentrate: concurrent use may be unnecessary and should be coordinated.
• Diuretics: monitor blood pressure changes when combined with icatibant.