Icatibant Zentiva (Icatibant Acetate)

Icatibant Zentiva acts on the bradykinin pathway to manage hereditary angioedema.

• Hereditary angioedema type I (C1‑inhibitor deficiency): provides rapid relief of swelling during acute attacks.
• Hereditary angioedema type II (dysfunctional C1‑inhibitor): reduces attack severity and duration.

• Icatibant acetate selectively blocks the bradykinin B2 receptor on vascular endothelial cells. By preventing bradykinin binding, it inhibits the downstream signaling that leads to vasodilation and increased vascular permeability, thereby curbing the swelling and pain 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 site of administration.
• Redness or erythema: localized skin flushing.
• Swelling at injection site: mild to moderate edema.
• Nausea: transient gastrointestinal upset.
• Headache: mild to moderate intensity.
• Dizziness: occasional light‑headedness.

Serious or Rare Side Effects

• Anaphylaxis: severe allergic reaction requiring immediate medical attention.
• Angioedema of the face or throat: potentially life‑threatening swelling.
• Severe hypotension: marked drop in blood pressure.
• Urticaria: widespread hives.
• Thrombocytopenia: low platelet count observed rarely.

Before using Icatibant, consider the following safety measures.

• Pregnancy: safety not established; use only if potential benefit justifies the risk.
• Breastfeeding: unknown effects; weigh benefits against possible infant exposure.
• Renal impairment: no dosage adjustment required, but monitor renal function.
• Concomitant ACE inhibitors: may increase bradykinin levels; observe for enhanced angioedema.
• Hypersensitivity: discontinue immediately if severe allergic reaction occurs.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Icatibant can interact with other medicines that influence bradykinin or vascular tone.

Major Interactions (Avoid)

• ACE inhibitors: additive increase in bradykinin may precipitate angioedema.
• Neprilysin inhibitors (e.g., sacubitril): elevate bradykinin levels, raising risk of severe swelling.

Moderate Interactions (Monitor Closely)

• NSAIDs: may exacerbate edema in susceptible individuals.
• Estrogen‑containing therapies: can predispose to angioedema, requiring vigilance.
• Other B2 receptor antagonists: concurrent use may lead to unpredictable pharmacodynamics.