- Drugs List
- Therapeutic Indications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
Injection of icatibant.
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
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
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.
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
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 ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Last Full review Date: August 2021
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: www.nice.org.uk Last accessed: 11 August 2021
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Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content
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