Ibutilide

Generic name: ibutilide [ eye-BUE-til-ide ]
Brand name: Corvert

Drug class: Antiarrhythmics

Dosage form: Injection

Route of administration: Intravenous (IV)

Dose: intravenous solution (0.1 mg/mL)

Mechanism of action: Ibutilide is a class III antiarrhythmic agent that works by prolonging the action potential duration and refractory period of cardiac tissue, thereby stabilizing the heart’s rhythm. It blocks the delayed rectifier potassium current, which helps to restore normal heart rhythms in conditions like atrial fibrillation and atrial flutter.

Drug usage cases: Ibutilide is used to convert recent onset atrial fibrillation or atrial flutter to normal sinus rhythm. It is typically used in a hospital setting under careful monitoring due to the risk of significant arrhythmias.

Drug contra indications: Ibutilide should not be used in individuals with hypersensitivity to the drug, a prolonged QT interval, or severe heart block unless a pacemaker is present. Caution is advised in patients with electrolyte imbalances (especially hypokalemia or hypomagnesemia), severe heart failure, or other significant heart conditions.

Side effects: Common side effects include nausea, headache, and dizziness. Serious side effects may include:

• Arrhythmias: Potential for serious ventricular arrhythmias like Torsades de Pointes.
• Hypotension: May cause low blood pressure.
• QT prolongation: Can significantly prolong the QT interval, leading to potential heart rhythm issues.

Warnings: Ibutilide can cause serious arrhythmias, including Torsades de Pointes, which can be life-threatening. Continuous ECG monitoring is required during and for a period after administration. Correction of electrolyte imbalances before administration is crucial to minimize risks.

Use during pregnancy or breastfeeding: The safety of ibutilide during pregnancy and breastfeeding is not well established. It should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Caution should be exercised when administering to nursing mothers.