Ibutilide Fumarate
A to Z Drug Facts
Ibutilide Fumarate |
(ih-BYOO-tih-lide FEW-muh-rate) |
Corvert |
Class: Antiarrhythmic |
Action Prolongs atrial and ventricular action potential duration and refractoriness by activation of a slow inward current (predominantly sodium).
Indications Rapid conversion of recent onset atrial fibrillation or atrial flutter to sinus rhythm.
Contraindications Standard considerations.
ADULTS: IV Initial infusion: ³ 60 kg (³ 132 lbs) 1 mg (1 vial) infused over 10 min; < 60 kg (< 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.
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 hr 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.
Lab Test Interferences None well documented.
CV: 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.
Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy not established. Elderly patients: No age-related differences in safety and efficacy have been observed. Proarrhythmia: Potentially fatal ventricular arrhythmias may be induced or worsened. Ibutilide must be administered in a setting on continuous ECG monitoring by personnel trained in identification and treatment of acute ventricular arrhythmias, particularly polymorphic ventricular tachycardia. Hypokalemia/Hypomagnesemia: Should be corrected to reduce potential for proarrhythmia. Anticoagulation: Patients with atrial fibrillation > 2 to 3 days must be adequately anticoagulated, generally for ³ 2 weeks before attempted conversion.
PATIENT CARE CONSIDERATIONS |
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Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts