Ibutilide Side Effects
Not all side effects for ibutilide may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.
For the Consumer
Applies to ibutilide: parenteral solution for injection
Side effects include:
Generally well tolerated. Adverse events affecting the cardiovascular system (e.g., arrhythmogenic affects, affects on cardiac conduction, palpitation, hypotension, hypertension), nausea, and headache reported in ≤5.1% of patients.
For Healthcare Professionals
Applies to ibutilide: intravenous solution
Cardiovascular side effects were experienced by 25% of 586 patients in clinical trials. Like many other antiarrhythmic agents, ibutilide is potentially proarrhythmic. Ibutilide can induce sustained polymorphic ventricular tachycardia (VT) in 1.7% to 8.3% and nonsustained polymorphic VT in 1.7% to 2.7% of patients. Sustained monomorphic VT (0.2%), bundle branch block (1.9%), ventricular extrasystoles (5.1%), supraventricular extrasystoles (0.9%), hypotension or postural hypotension (2.0%), bradycardia or sinus bradycardia (1.2%), nodal arrhythmia (0.7%), congestive heart failure (0.5%), tachycardia or sinus tachycardia or supraventricular tachycardia in (2.7%), idioventricular rhythm (0.2%), hypertension (1.2%), QT segment prolongation in (1.2%), and syncope (0.3%) have been reported in patients receiving ibutilide therapy. The incidence of these events, except for syncope, was greater in treated patients compared with placebo.[Ref]
Ibutilide can cause potentially fatal arrhythmias, particular sustained polymorphic ventricular tachycardia (VT), usually in association with QT prolongation (torsades de pointes), but sometimes without documented QT prolongation. In clinical studies, these arrhythmias, which require cardioversion, occurred in 1.7% of treated patients during or within a number of hours of use of ibutilide. These arrhythmias can be reversed if treated promptly. It is essential that ibutilide be administered in a setting of continuous ECG monitoring and by personnel trained in identification and treatment of acute ventricular arrhythmias, particularly polymorphic VT.
Patients with atrial fibrillation of more than 2 to 3 days' duration must be adequately anticoagulated, generally for at least 2 weeks.
Patients with chronic atrial fibrillation have a strong tendency to revert after conversion to sinus rhythm and treatments to maintain sinus rhythm carry risks. Patients to be treated with ibutilide should be carefully selected such that the expected benefits of maintaining sinus rhythm outweigh the immediate risks of ibutilide and the risks of maintenance therapy, and benefits are likely to offer an advantage compared with alternative management.[Ref]
Gastrointestinal side effects appear limited to nausea in 1.9% of patients (compared with 0.8% with placebo).[Ref]
Nervous system side effects include headache in 3.6% of patients (compared with 3.1% with placebo).[Ref]
Renal failure has been reported in 0.3% of patients. A causal relationship has not been established.[Ref]
Dermatologic side effects including a case of dermatologic erythematous bullous lesions due to contact with ibutilide has been reported. Ibutilide fumarate contains a methanesulfonamide moiety.[Ref]
A medical student exposed to a 10 mL spill of ibutilide (0.017 mg/mL in 5% dextrose) immediately towel dried the exposed hands. Several hours elapsed before the hands were washed in soap and water. Six to eight hours postexposure the student noted a tingling and burning sensation on the hands and at 18 hours the areas of hand exposed to ibutilide were erythematous and red, with 2 bullous lesions on each hand. A single dose of topical betamethasone (0.05%) was applied and the areas were kept clean and dry. Resolution occurred after approximately 10 days. Rechallenge was refused.[Ref]
1. "Product Information. Corvert (ibutilide)." Pharmacia and Upjohn, Kalamazoo, MI.
2. Howard PA "Ibutilide: An antiarrhythmic agent for the treatment of atrial fibrillation or flutter." Ann Pharmacother 33 (1999): 38-47
3. Stambler BS, Wood MA, Ellenbogen KA, Perry KT, Wakefield LK, Vanderlugt JT, Abisamra FM, Ahern TS, Burger AJ, Cassidy DM "Efficacy and safety of repeated intravenous doses of ibutilide for rapid conversion of atrial flutter or fibrillation." Circulation 94 (1996): 1613-21
4. Volgman AS, Carberry PA, Stambler B, Lewis WR, Dunn GH, Perry KT, Vanderlugt JT, Kowey PR "Conversion efficacy and safety of intravenous ibutilide compared with intravenous procainamide in patients with atrial flutter or fibrillation." J Am Coll Cardiol 31 (1998): 1414-9
5. Amin NB, Borzak S, Householder S, Tisdale JE "Sinus bradycardia and multiple episodes of sinus arrest following administration of ibutilide." Heart 79 (1998): 628-9
6. Cropp JS, Antal EG, Talbert RL, et al. "Ibutilide: a new class III antiarrhythmic agent." Pharmacotherapy 17 (1997): 1-9
7. Granberry MC "Ibutilide: a new class III antiarrhythmic agent." Am J Health Syst Pharm 55 (1998): 255-60
8. Franz M, Geppert A, Kain R, Horl WH, Pohanka E "Acute renal failure after ibutilide." Lancet 353 (1999): 467
9. Dodds ES, Oberg KC "Erythematous bullous lesions on the dorsa of the hands due to contact exposure to ibutilide fumarate for injection." Pharmacotherapy 18 (1998): 880-2
More about ibutilide
- Other brands: Corvert
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