Lcatibant Viatris (Icatibant)

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

• Hereditary angioedema (type I): provides rapid reduction of subcutaneous and facial swelling during acute attacks.
• Hereditary angioedema (type II): alleviates airway and gastrointestinal edema in emergency episodes.
• Hereditary angioedema (C1‑inhibitor deficiency): restores normal vascular permeability during sudden attacks.

• Icatibant selectively blocks the bradykinin B2 receptor, 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, leading to rapid symptom relief.

Icatibant may cause a range of adverse reactions.

Common Side Effects

• Injection site pain: mild to moderate discomfort at the injection site.
• Redness or erythema: localized skin redness.
• Swelling at injection site: transient increase in local tissue volume.
• Headache: occasional mild to moderate headache.
• Nausea: occasional feeling of queasiness.
• Dizziness: transient light‑headedness.

Serious or Rare Side Effects

• Anaphylaxis: severe allergic reaction requiring immediate medical attention.
• Severe hypotension: marked drop in blood pressure.
• Angioedema unrelated to HAE: unexpected swelling in other body parts.
• Urticaria: widespread hives.
• Severe injection‑site necrosis: tissue damage at the site.
• Thrombocytopenia: low platelet count observed in rare cases.

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

• Confirm diagnosis: ensure the patient has hereditary angioedema before use.
• Hypersensitivity: assess for known allergy to icatibant or formulation components.
• Pregnancy and lactation: prescribe only if the potential benefit justifies the risk.
• Renal or hepatic impairment: monitor clinical response and adjust observation as needed.
• Concomitant ACE‑inhibitors: consider increased bradykinin levels that may affect efficacy.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Icatibant has limited drug‑drug interactions, but certain agents may modify its effectiveness or safety profile.

Major Interactions (Avoid)

• ACE inhibitors: may increase bradykinin levels, potentially reducing icatibant efficacy.
• Estrogen‑containing contraceptives: can exacerbate hereditary angioedema attacks.

Moderate Interactions (Monitor Closely)

• Other bradykinin B2 antagonists: additive pharmacologic effects may increase risk of hypotension.
• C1‑inhibitor concentrate: concurrent use may complicate clinical assessment of response.
• NSAIDs: may heighten risk of local injection‑site reactions.
• Diuretics: monitor blood pressure due to possible additive hypotensive effect.