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CARDIOVASCULAR SYSTEM › CARDIAC THERAPY › ANTIARRHYTHMICS, CLASS I AND III › Antiarrhythmics, class III
ibutilide
C01BD05
Forms & Strengths
- Injectable solution: 0.1 mg/mL in 10 mL vials
Adult Dosing
- Weight >= 60 kg: 1 mg (10 mL) IV infused over 10 minutes
- Weight < 60 kg: 0.01 mg/kg IV infused over 10 minutes
- If arrhythmia does not terminate within 10 minutes after infusion end, a second identical dose may be administered
Pediatric Dosing
- Safety and efficacy in pediatric patients have not been established
Indications
- Rapid conversion of recent-onset atrial fibrillation or atrial flutter to normal sinus rhythm
Mechanism of Action
- Class III antiarrhythmic agent that delays repolarization by blocking the slow inward sodium current and activating an outward potassium current
Contraindications
- Known hypersensitivity to ibutilide fumarate
- History of sustained polymorphic ventricular tachycardia (e.g., Torsades de Pointes)
Adverse Reactions
- Torsades de Pointes (prolonged QT interval)
- Sustained polymorphic ventricular tachycardia
- Nonsustained ventricular tachycardia
- Ventricular extrasystoles
- Atrioventricular block
- Bundle branch block
- Hypotension
- Headache
Drug Interactions
- Class Ia antiarrhythmics (e.g., disopyramide, quinidine, procainamide) - potential additive effects on QT prolongation
- Class III antiarrhythmics (e.g., amiodarone, sotalol, dofetilide) - increased risk of excessive QT prolongation and arrhythmias
- QT-prolonging drugs (e.g., phenothiazines, tricyclic antidepressants, certain antihistamines, fluoroquinolones) - increased risk of proarrhythmia
Curated Content: Needs Vetting Before Put to Clinical Use