ibutilide

medtigo

ibutilide

Brand Name :

Corvert

Synonyms :

ibutilide

Class :

Antidysrhythmic, III

Action and Spectrum

Actions and Spectrum:

ibutilide works by selectively blocking the potassium channels in heart muscle cells, prolonging the action potential’s duration and increasing the refractory period. This allows for restoring normal heart rhythm by interrupting the reentry circuits that can cause atrial fibrillation or atrial flutter. The exact mechanism of ibutilide affects these channels has yet to be fully understood.
ibutilide is primarily used to treat atrial fibrillation and atrial flutter, both types of irregular heart rhythms originating in the heart’s upper chambers (atria). It effectively restores normal sinus rhythm in patients with recent-onset or persistent atrial fibrillation, with success rates ranging from approximately 30% to 70%.
ibutilide may be combined with other medications or procedures, such as electrical cardioversion, to manage atrial fibrillation or atrial flutter. It is not practical to treat other types of irregular heart rhythms, such as ventricular tachycardia or ventricular fibrillation.

Dosing & Uses

Drug Interaction

Adverse Reaction

Frequency defined

1-10%

Bradycardia (2%)

Hypotension (2%)

QTc interval prolongation (<2%)

Headache (4%)

HTN (2%)

Palpitations (2%)

Nausea (>2%)

<1%

Erythematous bullous lesions

Renal failure

Ventricular tachycardia

Heart block

Heart failure

Nodal arrhythmia

Syncope

Torsades de pointes

Black Box Warning

Contraindication / Caution

Contraindications/caution:

Contraindications:

Known hypersensitivity: Individuals with known hypersensitivity to ibutilide or its components should not take this medication.
Baseline QT prolongation: ibutilide can cause prolongation of the QT interval, which measures the heart’s electrical activity. Patients with pre-existing QT prolongation or a history of torsades de pointes, a type of abnormal heart rhythm, should not take ibutilide.
Hypokalemia: Low potassium levels in the blood can increase the risk of arrhythmias and make it more challenging to control irregular heartbeats with medications such as ibutilide. Therefore, ibutilide is contraindicated in patients with hypokalemia.
Hypomagnesemia: Low magnesium levels in the blood can increase the risk of arrhythmias and make it more challenging to control irregular heartbeats with medications such as ibutilide. Therefore, ibutilide is contraindicated in patients with hypomagnesemia.
Severe renal impairment: ibutilide is primarily excreted through the kidneys, so patients with severe renal impairment may be at risk of accumulating the drug and its metabolites. Therefore, ibutilide is contraindicated in patients with severe renal impairment (creatinine clearance less than 20 mL/min).
Pregnancy and breast-feeding: The safety of ibutilide in pregnant or breastfeeding women has not been established, and the potential risks to the developing fetus or nursing infant are unknown. Therefore, ibutilide should be avoided in pregnant or breastfeeding women unless the potential benefits outweigh the risks.

Caution:

Cardiovascular disease: Patients with underlying cardiovascular disease, such as heart failure or coronary artery disease, may be at increased risk for adverse events when taking ibutilide. These patients should be closely monitored during treatment with ibutilide.
Electrolyte abnormalities: As mentioned earlier, ibutilide can cause electrolyte abnormalities, such as hypokalemia and hypomagnesemia, increasing the risk of arrhythmias. Patients with pre-existing electrolyte abnormalities should monitor their electrolyte levels closely during ibutilide treatment.
Renal impairment: Patients with mild to moderate renal impairment may require dose adjustments when taking ibutilide, as the drug is excreted primarily through the kidneys. Patients with severe renal impairment should not take ibutilide, as it is contraindicated in this population.
Hepatic impairment: Patients with hepatic impairment may require dose adjustments when taking ibutilide, as the drug is metabolized in the liver.
Use with other medications: ibutilide should be used cautiously in patients taking other medications that can prolong the QT interval, as this can increase the risk of arrhythmias. Examples of such medications include antibiotics, antipsychotics, and antidepressants.
Age: Elderly patients may be more sensitive to the effects of ibutilide and may require lower doses or more frequent monitoring during treatment.

Pregnancy / Lactation

Pregnancy consideration: Insufficient data available

Lactation:

Excretion of the drug in human breast milk is unknown
ibutilide should be avoided in pregnant or breastfeeding women unless the potential benefits outweigh the risks.

Pregnancy category:

Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester.

Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.

Category N: There is no data available for the drug under this category

Pharmacology

Pharmacology:

ibutilide works by blocking potassium channels in the heart, which prolongs the action potential duration and refractory period in the atrial and ventricular myocardium. This results in an antiarrhythmic effect by helping to prevent the reentry of abnormal electrical signals in the heart

Pharmacodynamics:

ibutilide has a relatively narrow therapeutic index, meaning that the therapeutic dose is close to the toxic dose. The drug can cause prolongation of the QT interval on the electrocardiogram, which can lead to a potentially life-threatening arrhythmia called torsades de pointes. Therefore, patients receiving ibutilide should be closely monitored for changes in their QT interval and other potential adverse effects.

Pharmacokinetics:

Absorption

ibutilide is administered intravenously and is rapidly and completely absorbed following injection.

Distribution

The volume of distribution of ibutilide is approximately 7 L/kg, suggesting that the drug is widely distributed throughout the body. The plasma protein binding of ibutilide is about 40-50%.

Metabolism

ibutilide is metabolized by the liver through the cytochrome P450 enzyme system, predominantly by the CYP3A4 isoform, into inactive metabolites.

Elimination and Excretion

The elimination half-life of ibutilide is approximately 6 hours. The drug is excreted primarily in the urine, with approximately 50-60% of the dose being excreted unchanged in the urine. The remaining portion of the drug is excreted in feces.

Adminstartion

Administration:

ibutilide is administered intravenously (IV) in a hospital or clinical setting. It is typically given as a single dose over 10 minutes. The recommended dose of ibutilide is based on the patient’s body weight and cardiac function and is usually between 0.01 and 0.025 mg/kg

Patient Information Leaflet

Patient information leaflet

Generic Name: ibutilide

Pronunciation: [ eye-BUE-til-ide ]

Why do we use ibutilide?

ibutilide is a class III antiarrhythmic medication primarily used to treat certain atrial arrhythmias, such as atrial fibrillation and atrial flutter. It works by blocking potassium channels in the heart, which helps prevent the reentry of abnormal electrical signals and restore normal heart rhythm.
ibutilide is typically used in hospital or clinical settings, where patients can be closely monitored for changes in their heart rhythm and potential adverse effects. It is often used when other treatments have been ineffective or not well-tolerated.

ibutilide

No data available for drug.

DRUG INTERACTION

ibutilide

&

ibutilide +

Contraindicated

Serious Use Alternative

Monitor Closely

Minor

ibutilide

No data available for drug.

DRUG INTERACTION

ibutilide

&

ibutilide +

Contraindicated

Serious Use Alternative

Monitor Closely

Minor

medtigo

ibutilide

Brand Name :

Synonyms :

Class :

Action and Spectrum

Dosing & Uses

Drug Interaction

Adverse Reaction

Black Box Warning

Contraindication / Caution

Pregnancy / Lactation

Pharmacology

Adminstartion

Patient Information Leaflet

CONTACT INFORMATION

ADDRESS