Icatibant

Icatibant is used in adults with C1-esterase-inhibitor deficiency for the symptomatic treatment of acute attacks of hereditary angioedema. However, Angioedema caused by medication from the ACE inhibitor class is not treated by Icatibant. It has been investigated for treating angioedema, liver disease, and burns and burn infections. Icatibant is classified as a peptidomimetic consisting of ten amino acids, which is a selective and specific antagonist of bradykinin B2 receptors. Icatibant sold under the brand name Firazy among others. Shire plc was given the first FDA approval for its Firazyr in 2011. However, as of 2011, Icatibant has orphan drug status in the United States as per FDA approvals.

Dosage Forms & Strengths

Icatibant is sold as SC injection in a prefilled syringe in 30mg (10 mg/mL). in the treatment of Hereditary Angioedema, the Bradykinin B2 receptor antagonist indicated for the treatment of acute attacks is 3 mL (30 mg) SC in the abdominal area. If the desired response is not achieved from this dose, an injection of 30 mg can be administered at intervals of at least 6 hr, not to exceed 3 injections in 24 hours.

The price of Icatibant

In the USA, the price of generic subcutaneous solution (10 mg/mL) is around $2,950 for a supply of 3 milliliters and the price of Firazyr subcutaneous solution (10 mg/mL) is around $11,647 for a supply of 3 milliliters. The price is much lower in the developing world. In India, the price of one viral is around USD2.5.

How does it work?

Icatibant is a peptide-based hormone, it forms naturally in local tissues in response to trauma. This results in increased vessel permeability blood vessel dilation, and contraction in smooth muscle cells. It is a key mediator of pain and its excess is associated with typical symptoms of inflammation like swelling, redness, overheating, and pain. The resolution of these symptoms is done by activating bradykinin B2 receptors. Icatibant is a bradykinin inhibitor. Its actions block the binding of native bradykinin to the bradykinin B2 receptor, mediating the levels to normal, controlling symptoms of inflammation.

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