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Indications and Dosage
Intravenous
Atrial fibrillation or flutter Adult: As fumarate: ≥60 kg: 1 mg over 10 min; <60 kg: 10 mcg/kg over 10 min. Stop infusion as soon as arrhythmia is terminated. Repeat the course if arrhythmia continues 10 min after completion of the 1st dose.
Elderly: Start at the lower end of dosing range. |
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Contraindications
Lactation. QTc interval >440 msec.
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Special Precautions
Chronic atrial fibrillation. Correct hypokalaemia and hypomagnesaemia before initiation of therapy. Monitor ECG during and for at least 4 hr after infusion. Monitor for heart block. Pregnancy.
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Adverse Reactions
Heart block, hypotension, hypertension, bradycardia, palpitations; headache; nausea, vomiting.
Potentially Fatal: Arrhythmias (including torsade de pointes). |
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IV/Parenteral: C
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Overdosage
Symptoms: CNS depression, convulsions, arrhythmias. Management: Supportive. Avoid antiarrhythmics.
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Drug Interactions
Additive prolongation of refractoriness with other antiarrhythmics. Increased proarrhythmic risks with drugs that prolong QT interval e.g. TCAs, phenothiazines, cisapride, sparfloxacin, gatifloxacin, moxifloxacin, erythromycin, astemizole. May mask signs of digoxin toxicity.
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Action
Description: Ibutilide is a methanesulfonanilide derivative class III antiarrhythmic agent. It prolongs repolarisation and refractoriness without affecting conduction. Antiarrhythmic action may result from activation of slow, inward current (predominantly sodium) at very low concentrations.
Onset: Approx 90 min after start of infusion. Pharmacokinetics: Distribution: Protein-binding: About 40%. Metabolism: Hepatic; via oxidation. Excretion: Via urine (82%, 7% as unchanged drug and metabolites); via faeces (19%). 2-12 hr (elimination half-life). |
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Storage
Store at controlled room temperature 20-25°C (68-77°F).
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MIMS Class
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