19 . January , 2019 - Saturday
Check todays hot topics or new products

Find a Drug: Advanced

Please Sign in or Register

All about: Ibutilide Fumarate

Big Image Pronouncation: (ih-BYOO-tih-lide FEW-muh-rate)
Class: Antiarrhythmic agent

Trade Names:
Corvert
- Solution 0.1 mg/mL

Mechanism of Action

Pharmacology

Prolongs atrial and ventricular action potential duration and refractoriness by activation of a slow inward current (predominantly sodium).

Pharmacokinetics

Distribution

Vd at steady state is approximately 11 L/kg. Approximately 40% is protein bound.

Metabolism

8 metabolites are formed via oxidation. Only the ω-hydroxy metabolite possesses activity similar to ibutilide.

Elimination

Cl is 29 mL/min/kg. Approximately 82% is excreted in the urine (7% unchanged) and approximately 19% in feces. The mean t ½ is approximately 6 h (range is 2 to 12 h).

Indications and Usage

Rapid conversion of recent onset atrial fibrillation or atrial flutter to sinus rhythm.

Contraindications

Standard considerations.

Dosage and Administration

Adults

IV Initial infusion: At least 60 kg (at least 132 lbs) 1 mg (1 vial) infused over 10 min; less than 60 kg (less than 132 lbs) 0.01 mg/kg (0.1 mL/kg) infused over 10 min. If the arrhythmia does not terminate within 10 min after the end of the initial infusion, a second 10 min infusion of equal strength may be administered 10 min after completion of the first infusion.

General Advice

  • For IV administration only.
  • May be administered undiluted or further diluted in 50 mL of either normal saline or D5W.

Storage/Stability

  • Store unopened vials at room temperature (59° to 86°F).
  • Diluted medication may be stored for up to 24 h at room temperature (59° to 86°F), or for 48 h refrigerated (36° to 46°F).

Drug Interactions

Concomitant Class Ia and III antiarrhythmic agents (eg, amiodarone, disopyramide, procainamide, quinidine, sotalol)

Do not give concurrently. Withhold for 5 half-lives prior to and for 4 h after ibutilide infusion.

Medications that prolong the QT interval (eg, phenothiazines, tricyclic and tetracyclic antidepressants)

Potential for proarrhythmia may be increased.

Digoxin

Cardiotoxicity (supraventricular arrhythmia) due to excessive digoxin concentrations may be masked.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Cardiovascular

Nonsustained monomorphic ventricular extrasystoles and ventricular tachycardia (VT); sinus; supraventricular sustained and nonsustained polymorphic VT; hypotension; postural hypotension; hypertension; bundle branch block; sustained polymorphic VT; AV block; sinus bradycardia; QT segment prolongation; palpitations.

CNS

Headache.

GI

Nausea.

Precautions

Warnings

Experienced physician/equipped facility.

Potentially fatal arrhythmias have occurred and require administration in a setting of continuous ECG monitoring and personnel trained in identification and treatment of acute ventricular arrhythmias, particularly polymorphic ventricular tachycardia.

Patient selection

Patients with chronic atrial fibrillation have a strong tendency to revert after conversion to sinus rhythm, and treatment to maintain sinus rhythms carry risks. Patients for ibutilide therapy should be carefully selected.


Pregnancy

Category C .

Lactation

Undetermined.

Children

Safety and efficacy not established.

Elderly

No age-related differences in safety and efficacy have been observed.

Hypokalemia/Hypomagnesemia

Correct hypokalemia/hypomagnesemia to reduce potential for proarrhythmia.

Anticoagulation

Patients with atrial fibrillation more than 2 to 3 days must be adequately anticoagulated, generally for at least 2 wk before attempted conversion.

Overdosage

Symptoms

CNS toxicity, rapid gasping breathing, convulsions, ventricular ectopy, ventricular tachycardia, AV block.

Patient Information

  • Advise patient that this is a short-term treatment for arrhythmia, and long-term oral medications will likely be required for control if this therapy is successful.
  • Teach patient and family how to take blood pressure and pulse for home management with medications.
  • Advise patient to report any chest pain, shortness of breath, palpitations, fluttering in the chest, headache, or faintness immediately to the health care provider while the medication is infusing.

Recent Drug Updates at DrugIndexOnline:





Cheratussin AC Cheratussin AC
Generic Name: codeine and guaifenesin (KO deen and gwye FEN a sin) Brand Names: Bitex Liquid, Brontex, Cheracol with Codeine, Cheratussin AC, Codafen, Glydeine, Guaiatussin AC, Guaifen AC, Guaifen-C, Guaifenesin AC Liquid, Guiatuss AC, Guiatussin with Codeine, Halotussin AC, Iophen-C NR, more...

Co-Lav Local Co-Lav Local
Some commonly used brand names are: In the U.S.— Co-Lav Colovage Colyte Colyte-flavored Colyte with Flavor Packs Go-Evac GoLYTELY NuLYTELY NuLYTELY, Cherry Flavor OCL In Canada— Colyte GoLYTELY Klean-Prep Peglyte PEG-3350 & Electrolytes Category Evacuant (bowel) Descr more...

Detrol Detrol
Generic name: Tolterodine tartrate Brand names: Detrol LA, Detrol Why is Detrol prescribed? Detrol combats symptoms of overactive bladder, including frequent urination, urgency (increased need to urinate), and urge incontinence (inability to control urination). The drug works by blocking the ner more...

Doral Doral
Generic name: Quazepam Brand names: Doral Why is Doral prescribed? Doral, a sleeping medication available in tablet form, is taken as short-term treatment for insomnia. Symptoms of insomnia may include difficulty falling asleep, frequent awakenings throughout the night, or very early morning awa more...

grepafloxacin grepafloxacin
Generic Name: grepafloxacin (grep a FLOX a sin) Brand Names: Raxar What is grepafloxacin? Grepafloxacin nasal was withdrawn from the U.S. market in 1999. Grepafloxacin is an antibiotic in a class of drugs called fluoroquinolones. Grepafloxacin fights bacteria in your body. Grepafloxacin more...

Lopressor Lopressor
Generic Name: metoprolol tartrate Dosage Form: Tablets and injection Lopressor®                                   &nb more...

Miocarpine Ophthalmic Miocarpine Ophthalmic
Some commonly used brand names are: In the U.S.— Adsorbocarpine Akarpine Isopto Carpine Ocu-Carpine Ocusert Pilo-20 Ocusert Pilo-40 Pilagan Pilocar Pilopine HS Piloptic-1/2 Piloptic-1 Piloptic-2 Piloptic-3 Piloptic-4 Piloptic-6 Pilostat In Canada— Isopto Carpine Minims Pilocarpine more...

Procainamide HCl Procainamide HCl
Pronouncation: (pro-CANE-uh-mide HIGH-droe-KLOR-ide) Class: Antiarrhythmic agent Trade Names: Procanbid - Tablets, sustained-release 500 mg - Tablets, extended-release 1000 mg Trade Names: Pronestyl - Tablets 250 mg - Tablets 375 mg - Tablets 500 mg - Capsules 250 mg - C more...