This site is intended for UK healthcare professionals
Medscape UK Univadis Logo
Medscape UK Univadis Logo

Icatibant parenteral

Updated 2 Feb 2023 | Hereditary angioedema


Injection of icatibant.

Drugs List

  • FIRAZYR 30mg/3ml injection
  • icatibant 30mg/3ml injection
  • Therapeutic Indications


    Hereditary angioedema

    Icatibant is indicated for treatment of acute attacks of hereditary angioedema in adults, adolescents and children aged 2 years and older, with C1-esterase-inhibitor deficiency.



    30mg by subcutaneous injection.

    Further 30mg injections can be given in 6 hour intervals up to a maximum of 3 injections in a 24 hour period and only if required to control the attack.


    Children aged 2 to 18 years
    Body Weight
    Over 65kg: 30mg
    51kg to 65kg: 25mg
    41kg to 50kg: 20mg
    26kg to 40kg: 15mg
    12kg to 25kg: 10mg


    For subcutaneous injection only.

    Self-administration may be considered after appropriate injection technique training and only if considered suitable by a physician experienced in the diagnosis and treatment of angioedema.


    Children under 2 years

    Precautions and Warnings

    Patients over 65 years
    Acute ischaemic heart disease
    Recent cerebrovascular accident
    Unstable angina

    Advise ability to drive/operate machinery may be affected by side effects
    Laryngeal attacks: Assess patient in suitable facilities before discharge
    Administer injection slowly
    Treatment to be initiated by medically trained personnel
    Breastfeeding: Do not breastfeed & discard milk for 12 hours after therapy
    Patient should seek medical advice if usual relief is diminished

    Pregnancy and Lactation


    Use icatibant with caution in pregnancy.

    The manufacturer advises caution if icatibant is used during pregnancy. Although there is no clinical data on exposed pregnancies, animal studies have shown effects on uterine implantation and parturition, but the risk to humans is unknown.

    In the event of an attack of hereditary angioedema in pregnant women, other treatments should be considered due to the lack of information regarding the effects of icatibant on pregnancy. (Briggs 2015)


    Use icatibant with caution in breastfeeding.

    The manufacturer advises caution if icatibant is used during breastfeeding. It is unknown whether icatibant is excreted in human breast milk. However, animal studies have shown that icatibant is excreted in the milk of lactating rats as similar concentrations to in maternal blood. The molecular weight (around 1305) should limit excretion into mature breast milk but mean elimination half-life (1.4 hours). The lack of plasma protein binding may allow some excretion and the effect on a breastfed infant is unknown. As the drug is a peptide, it may be digested in the infant's gut but the infant should be monitored for the most common side effects: pyrexia, increased transaminases, dizziness and rash.

    The manufacturer notes that breastfeeding women should not breastfeed for 12 hours after icatibant treatment.

    Side Effects

    Abnormal liver function tests
    Bruising at injection site
    Burning (injection site)
    Erythema at injection site
    Haematoma (injection site)
    Increases in serum transaminases (transient)
    Irritation (injection site)
    Itching (injection site)
    Local pain (injection site)
    Sensation of pressure
    Sensation of warmth
    Skin pain
    Swelling (injection site)


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full review Date: August 2021

    Reference Sources

    Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 10th edition (2015) ed. Briggs, G., Freeman, R. Wolters Kluwer Health, Philadelphia.

    Summary of Product Characteristics: Firazyr 30mg solution for injection pre-filled syringe. Shire Orphan Therapies GmbH. Revised October 2020.

    NICE Evidence Services Available at: Last accessed: 11 August 2021

    Access the full UK drug database with a FREE Medscape UK Account
    It takes just a few minutes, and you’ll get unlimited access to information on over 11,000 UK drugs.
    Register for Free

    Already a member? Log in

    Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content

    FDB Logo

    FDB Disclaimer : FDB Multilex is intended for the use of healthcare professionals and is provided on the basis that the healthcare professionals will retain FULL and SOLE responsibility for deciding what treatment to prescribe or dispense for any particular patient or circumstance.