ibutilide (Rx)

Brand and Other Names:Corvert

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 0.1mg/mL

Atrial Fibrillation/Flutter

<60 kg: 0.01 mg/kg (0.1 mL/kg) IV infusion repeat after 10 minutes PRN  

>60 kg: 1 mg (one vial) IV infusion, repeat after 10 minutes PRN

Renal Impairment

Dose adjustment not necessary

Hepatic Impairment

Dose adjustment not necessary

Safety & efficacy not established

Next:

Interactions

Interaction Checker

and ibutilide

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            Contraindicated (52)

            • amiodarone

              amiodarone and ibutilide both increase QTc interval. Contraindicated. Class III antiarrhythmics should not be given concomitantly or within 4 hr post infusion of ibutilide because of protential for prolonged refractoriness

            • amitriptyline

              amitriptyline and ibutilide both increase QTc interval. Contraindicated.

            • amoxapine

              amoxapine and ibutilide both increase QTc interval. Contraindicated.

            • artemether/lumefantrine

              ibutilide and artemether/lumefantrine both increase QTc interval. Contraindicated.

            • chlorpromazine

              chlorpromazine and ibutilide both increase QTc interval. Contraindicated.

            • clarithromycin

              clarithromycin and ibutilide both increase QTc interval. Contraindicated.

            • clomipramine

              clomipramine and ibutilide both increase QTc interval. Contraindicated.

            • desipramine

              desipramine and ibutilide both increase QTc interval. Contraindicated.

            • disopyramide

              disopyramide and ibutilide both increase QTc interval. Contraindicated.

            • dofetilide

              dofetilide and ibutilide both increase QTc interval. Contraindicated.

            • doxepin

              doxepin and ibutilide both increase QTc interval. Contraindicated.

            • dronedarone

              dronedarone and ibutilide both increase QTc interval. Contraindicated.

            • droperidol

              droperidol and ibutilide both increase QTc interval. Contraindicated.

            • epinephrine

              epinephrine and ibutilide both increase QTc interval. Contraindicated.

            • epinephrine racemic

              epinephrine racemic and ibutilide both increase QTc interval. Contraindicated.

            • erythromycin base

              erythromycin base and ibutilide both increase QTc interval. Contraindicated.

            • erythromycin ethylsuccinate

              erythromycin ethylsuccinate and ibutilide both increase QTc interval. Contraindicated.

            • erythromycin lactobionate

              erythromycin lactobionate and ibutilide both increase QTc interval. Contraindicated.

            • erythromycin stearate

              erythromycin stearate and ibutilide both increase QTc interval. Contraindicated.

            • fingolimod

              fingolimod increases effects of ibutilide by pharmacodynamic synergism. Contraindicated. Due to increased risk of bradycardia, AV block, and torsade de pointes, concomitant use is contraindicated.

              fingolimod and ibutilide both increase QTc interval. Contraindicated.

            • fluconazole

              fluconazole and ibutilide both increase QTc interval. Contraindicated.

            • fluphenazine

              fluphenazine and ibutilide both increase QTc interval. Contraindicated.

            • goserelin

              goserelin increases toxicity of ibutilide by QTc interval. Contraindicated. Increases risk of torsades de pointes.

            • haloperidol

              haloperidol and ibutilide both increase QTc interval. Contraindicated.

            • imipramine

              imipramine and ibutilide both increase QTc interval. Contraindicated.

            • indapamide

              ibutilide and indapamide both increase QTc interval. Contraindicated.

            • ketoconazole

              ibutilide and ketoconazole both increase QTc interval. Contraindicated.

            • leuprolide

              leuprolide increases toxicity of ibutilide by QTc interval. Contraindicated. Increases risk of torsades de pointes.

            • levoketoconazole

              ibutilide and levoketoconazole both increase QTc interval. Contraindicated.

            • lofepramine

              lofepramine and ibutilide both increase QTc interval. Contraindicated.

            • lumefantrine

              ibutilide and lumefantrine both increase QTc interval. Contraindicated.

            • maprotiline

              maprotiline and ibutilide both increase QTc interval. Contraindicated.

            • moxifloxacin

              ibutilide and moxifloxacin both increase QTc interval. Contraindicated.

            • nilotinib

              ibutilide and nilotinib both increase QTc interval. Contraindicated.

            • nortriptyline

              nortriptyline and ibutilide both increase QTc interval. Contraindicated.

            • octreotide

              ibutilide and octreotide both increase QTc interval. Contraindicated.

            • octreotide (Antidote)

              ibutilide and octreotide (Antidote) both increase QTc interval. Contraindicated.

            • pentamidine

              ibutilide and pentamidine both increase QTc interval. Contraindicated.

            • perphenazine

              perphenazine and ibutilide both increase QTc interval. Contraindicated.

            • pimozide

              ibutilide and pimozide both increase QTc interval. Contraindicated.

            • procainamide

              ibutilide and procainamide both increase QTc interval. Contraindicated.

            • prochlorperazine

              prochlorperazine and ibutilide both increase QTc interval. Contraindicated.

            • promazine

              promazine and ibutilide both increase QTc interval. Contraindicated.

            • promethazine

              promethazine and ibutilide both increase QTc interval. Contraindicated.

            • protriptyline

              protriptyline and ibutilide both increase QTc interval. Contraindicated.

            • quinidine

              quinidine and ibutilide both increase QTc interval. Contraindicated.

            • sotalol

              ibutilide and sotalol both increase QTc interval. Contraindicated.

            • thioridazine

              thioridazine and ibutilide both increase QTc interval. Contraindicated.

            • trazodone

              trazodone and ibutilide both increase QTc interval. Contraindicated.

            • trifluoperazine

              trifluoperazine and ibutilide both increase QTc interval. Contraindicated.

            • trimipramine

              trimipramine and ibutilide both increase QTc interval. Contraindicated.

            • ziprasidone

              ibutilide and ziprasidone both increase QTc interval. Contraindicated.

            Serious - Use Alternative (90)

            • adagrasib

              adagrasib, ibutilide. Either increases effects of the other by QTc interval. Avoid or Use Alternate Drug. Each drug prolongs the QTc interval, which may increased the risk of Torsade de pointes, other serious arryhthmias, and sudden death. If coadministration unavoidable, more frequent monitoring is recommended for such patients.

            • alfuzosin

              alfuzosin and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • amisulpride

              amisulpride and ibutilide both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.

            • anagrelide

              anagrelide and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • apomorphine

              apomorphine and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • aripiprazole

              aripiprazole and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • arsenic trioxide

              arsenic trioxide and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • artemether

              artemether and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • asenapine transdermal

              asenapine transdermal and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • atomoxetine

              atomoxetine and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • buprenorphine

              buprenorphine and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • buprenorphine buccal

              buprenorphine buccal and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • buprenorphine subdermal implant

              buprenorphine subdermal implant and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • buprenorphine transdermal

              buprenorphine transdermal and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • buprenorphine, long-acting injection

              buprenorphine, long-acting injection and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • ceritinib

              ceritinib and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • clozapine

              clozapine and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • dasatinib

              dasatinib and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • degarelix

              degarelix and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • desflurane

              desflurane and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • dolasetron

              dolasetron and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • donepezil

              donepezil and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • efavirenz

              efavirenz and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • eliglustat

              eliglustat and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • encorafenib

              encorafenib and ibutilide both increase QTc interval. Avoid or Use Alternate Drug. Encorafenib is associated with dose-dependent QTc interval prolongation. Avoid with drugs known to prolong QT interval.

            • entrectinib

              ibutilide and entrectinib both increase QTc interval. Avoid or Use Alternate Drug.

            • eribulin

              eribulin and ibutilide both increase QTc interval. Avoid or Use Alternate Drug. Potential for enhanced QTc-prolonging effects; if concurrent use is necessary then ECG monitoring is recommended.

            • escitalopram

              escitalopram increases toxicity of ibutilide by QTc interval. Avoid or Use Alternate Drug.

            • fexinidazole

              fexinidazole and ibutilide both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels and/or prolong QT interval.

            • flecainide

              flecainide and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • fluoxetine

              fluoxetine and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • fluvoxamine

              fluvoxamine and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • formoterol

              formoterol and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • foscarnet

              foscarnet and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • gadobenate

              gadobenate and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • gemifloxacin

              gemifloxacin and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • gilteritinib

              gilteritinib and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • glasdegib

              ibutilide and glasdegib both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, monitor for increased risk of QTc interval prolongation.

            • granisetron

              granisetron and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • histrelin

              histrelin increases toxicity of ibutilide by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.

            • hydroxychloroquine sulfate

              hydroxychloroquine sulfate and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • hydroxyzine

              hydroxyzine and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • iloperidone

              ibutilide and iloperidone both increase QTc interval. Avoid or Use Alternate Drug.

            • inotuzumab

              inotuzumab and ibutilide both increase QTc interval. Avoid or Use Alternate Drug. If unable to avoid concomitant use, obtain ECGs and electrolytes before and after initiation of any drug known to prolong QTc, and periodically monitor as clinically indicated during treatment.

            • isoflurane

              isoflurane and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • ivosidenib

              ivosidenib and ibutilide both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of QTc prolonging drugs with ivosidenib or replace with alternate therapies. If coadministration of a QTc prolonging drug is unavoidable, monitor for increased risk of QTc interval prolongation.

            • lapatinib

              ibutilide and lapatinib both increase QTc interval. Avoid or Use Alternate Drug.

            • lefamulin

              lefamulin and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • levofloxacin

              ibutilide and levofloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • lithium

              lithium and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • macimorelin

              macimorelin and ibutilide both increase QTc interval. Avoid or Use Alternate Drug. Macimorelin causes an increase of ~11 msec in the corrected QT interval. Avoid coadministration with drugs that prolong QT interval, which could increase risk for developing torsade de pointes-type ventricular tachycardia. Allow sufficient washout time of drugs that are known to prolong the QT interval before administering macimorelin.

            • mefloquine

              mefloquine increases toxicity of ibutilide by QTc interval. Avoid or Use Alternate Drug. Mefloquine may enhance the QTc prolonging effect of high risk QTc prolonging agents.

            • methadone

              ibutilide and methadone both increase QTc interval. Avoid or Use Alternate Drug.

            • mirtazapine

              mirtazapine and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • mobocertinib

              mobocertinib and ibutilide both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, reduce mobocertinib dose and monitor QTc interval more frequently.

            • ofloxacin

              ibutilide and ofloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • olanzapine

              olanzapine and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • ondansetron

              ibutilide and ondansetron both increase QTc interval. Avoid or Use Alternate Drug. Avoid with congenital long QT syndrome; ECG monitoring recommended with concomitant medications that prolong QT interval, electrolyte abnormalities, CHF, or bradyarrhythmias.

            • oxaliplatin

              oxaliplatin and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • paliperidone

              ibutilide and paliperidone both increase QTc interval. Avoid or Use Alternate Drug.

            • panobinostat

              ibutilide and panobinostat both increase QTc interval. Avoid or Use Alternate Drug. Panobinostat is known to significantly prolong QT interval. Panobinostat prescribing information states use with drugs known to prolong QTc is not recommended.

            • paroxetine

              ibutilide and paroxetine both increase QTc interval. Avoid or Use Alternate Drug.

            • pimavanserin

              ibutilide and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug. Coadministration may increase the risk of QT prolongation and cardiac arrhythmia.

            • pitolisant

              ibutilide and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.

            • posaconazole

              ibutilide and posaconazole both increase QTc interval. Avoid or Use Alternate Drug.

            • primaquine

              primaquine and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • ranolazine

              ibutilide and ranolazine both increase QTc interval. Avoid or Use Alternate Drug.

            • ribociclib

              ribociclib and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • risperidone

              ibutilide and risperidone both increase QTc interval. Avoid or Use Alternate Drug.

            • romidepsin

              ibutilide and romidepsin both increase QTc interval. Avoid or Use Alternate Drug.

            • sertraline

              sertraline and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • sevoflurane

              sevoflurane and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • siponimod

              siponimod, ibutilide. Either increases effects of the other by QTc interval. Avoid or Use Alternate Drug. Because of the potential additive effects on heart rate, siponimod should generally not be initiated in patients taking QT prolonging drugs with known arrhythmogenic properties, heart rate lowering calcium channel blockers, or other drugs that may decrease heart rate. If treatment considered, obtain cardiology consult regarding switching to non-heart-rate lowering drugs or appropriate monitoring for treatment initiation.

            • solifenacin

              solifenacin and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • sulfamethoxazole

              sulfamethoxazole and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • sunitinib

              sunitinib and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • tacrolimus

              tacrolimus and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • telavancin

              ibutilide and telavancin both increase QTc interval. Avoid or Use Alternate Drug.

            • tetrabenazine

              tetrabenazine and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            • toremifene

              ibutilide and toremifene both increase QTc interval. Avoid or Use Alternate Drug. Concurrent use of toremifene with agents causing QT prolongation should be avoided. If concomitant use is required it's recommended that toremifene be interrupted. If interruption not possible, patients requiring therapy with a drug that prolongs QT should be closely monitored. ECGs should be obtained for high risk patients.

            • trimethoprim

              ibutilide and trimethoprim both increase QTc interval. Avoid or Use Alternate Drug.

            • triptorelin

              triptorelin increases toxicity of ibutilide by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.

            • tropisetron

              ibutilide and tropisetron both increase QTc interval. Avoid or Use Alternate Drug.

            • umeclidinium bromide/vilanterol inhaled

              ibutilide increases toxicity of umeclidinium bromide/vilanterol inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.

            • vandetanib

              ibutilide, vandetanib. Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug. Avoid coadministration with drugs known to prolong QT interval; if a drug known to prolong QT interval must be used, more frequent ECG monitoring is recommended.

            • vemurafenib

              vemurafenib and ibutilide both increase QTc interval. Avoid or Use Alternate Drug. Concomitant use of vemurafenib with drugs that prolong QT interval is not recommended.

            • venlafaxine

              ibutilide and venlafaxine both increase QTc interval. Avoid or Use Alternate Drug.

            • vilanterol/fluticasone furoate inhaled

              ibutilide increases toxicity of vilanterol/fluticasone furoate inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.

            • voriconazole

              ibutilide and voriconazole both increase QTc interval. Avoid or Use Alternate Drug.

            • vorinostat

              vorinostat and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.

            Monitor Closely (43)

            • albuterol

              albuterol and ibutilide both increase QTc interval. Use Caution/Monitor.

            • arformoterol

              arformoterol and ibutilide both increase QTc interval. Use Caution/Monitor.

            • asenapine

              asenapine and ibutilide both increase QTc interval. Use Caution/Monitor.

            • azithromycin

              azithromycin and ibutilide both increase QTc interval. Modify Therapy/Monitor Closely.

            • bedaquiline

              ibutilide and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closely

            • bosutinib

              bosutinib and ibutilide both increase QTc interval. Use Caution/Monitor.

            • capecitabine

              capecitabine and ibutilide both increase QTc interval. Use Caution/Monitor.

            • ciprofloxacin

              ciprofloxacin and ibutilide both increase QTc interval. Use Caution/Monitor. Ciprofloxacin elicits minimal effects on QT interval. Caution if used in combination with other drugs known to affect QT interval or in patients with other risk factors.

            • citalopram

              ibutilide and citalopram both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.

            • crizotinib

              crizotinib and ibutilide both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.

            • dabrafenib

              dabrafenib and ibutilide both increase QTc interval. Use Caution/Monitor.

            • deutetrabenazine

              ibutilide and deutetrabenazine both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).

            • ezogabine

              ezogabine, ibutilide. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Slight and transient QT-prolongation observed with ezogabine, particularly when dose titrated to 1200 mg/day. QT interval should be monitored when ezogabine is prescribed with agents known to increase QT interval.

            • floxuridine

              floxuridine and ibutilide both increase QTc interval. Use Caution/Monitor.

            • fostemsavir

              ibutilide and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.

            • gemtuzumab

              ibutilide and gemtuzumab both increase QTc interval. Use Caution/Monitor.

            • hawthorn

              hawthorn increases effects of ibutilide by pharmacodynamic synergism. Use Caution/Monitor.

            • indacaterol, inhaled

              indacaterol, inhaled, ibutilide. QTc interval. Use Caution/Monitor. Drugs that are known to prolong the QTc interval may have an increased the risk of ventricular arrhythmias.

            • itraconazole

              ibutilide and itraconazole both increase QTc interval. Use Caution/Monitor.

            • lenvatinib

              ibutilide and lenvatinib both increase QTc interval. Use Caution/Monitor. Lenvatinib prescribing information recommends monitoring ECG closely when coadministered with QT prolonging drugs.

            • lofexidine

              ibutilide and lofexidine both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended.

            • mifepristone

              mifepristone, ibutilide. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.

            • olodaterol inhaled

              ibutilide and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmias

            • osilodrostat

              osilodrostat and ibutilide both increase QTc interval. Use Caution/Monitor.

            • osimertinib

              osimertinib and ibutilide both increase QTc interval. Use Caution/Monitor. Conduct periodic monitoring with ECGs and electrolytes in patients taking drugs known to prolong the QTc interval.

            • oxaliplatin

              oxaliplatin will increase the level or effect of ibutilide by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.

            • ozanimod

              ozanimod and ibutilide both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.

            • pasireotide

              ibutilide and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.

            • pazopanib

              ibutilide and pazopanib both increase QTc interval. Modify Therapy/Monitor Closely.

            • ponesimod

              ponesimod, ibutilide. Either increases effects of the other by QTc interval. Use Caution/Monitor. Consult cardiologist if considering treatment. Class III (eg, amiodarone, dofetilide, sotalol) anti-arrhythmic drugs have been associated with cases of torsades de pointes in patients with bradycardia.

            • quetiapine

              quetiapine, ibutilide. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Avoid use with drugs that prolong QT and in patients with risk factors for prolonged QT interval. Postmarketing cases show QT prolongation with overdose in patients with concomitant illness or with drugs known to cause electrolyte imbalance or prolong QT.

            • quinine

              ibutilide and quinine both increase QTc interval. Use Caution/Monitor.

            • rilpivirine

              ibutilide increases toxicity of rilpivirine by QTc interval. Use Caution/Monitor. Rilpivirine should be used with caution when co-administered with a drug with a known risk of Torsade de Pointes.

              rilpivirine increases toxicity of ibutilide by QTc interval. Use Caution/Monitor. Rilpivirine should be used with caution when co-administered with a drug with a known risk of Torsades de Pointes.

            • saquinavir

              saquinavir increases toxicity of ibutilide by QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available. Increased risk of QT prolongation and cardiac arrhythmias.

            • selpercatinib

              selpercatinib increases toxicity of ibutilide by QTc interval. Use Caution/Monitor.

            • sevelamer

              sevelamer decreases levels of ibutilide by increasing elimination. Use Caution/Monitor.

            • sodium sulfate/?magnesium sulfate/potassium chloride

              sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of ibutilide by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

            • sodium sulfate/potassium sulfate/magnesium sulfate

              sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of ibutilide by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. .

            • sorafenib

              sorafenib and ibutilide both increase QTc interval. Use Caution/Monitor.

            • tipranavir

              tipranavir increases toxicity of ibutilide by QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available. Increased risk of QT prolongation and cardiac arrhythmias.

            • triclabendazole

              triclabendazole and ibutilide both increase QTc interval. Use Caution/Monitor.

            • valbenazine

              valbenazine and ibutilide both increase QTc interval. Use Caution/Monitor.

            • voclosporin

              voclosporin, ibutilide. Either increases effects of the other by QTc interval. Use Caution/Monitor.

            Minor (2)

            • chloroquine

              chloroquine increases toxicity of ibutilide by QTc interval. Minor/Significance Unknown.

            • lily of the valley

              ibutilide, lily of the valley. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown.

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            Adverse Effects

            1-10%

            Headache (4%)

            Bradycardia (2%)

            HTN (2%)

            Hypotension (2%)

            Palpitations (2%)

            QTc interval prolongation (<2%)

            Nausea (>2%)

            < 1%

            Heart failure

            Erythematous bollous lesions

            Nodal arrythmia

            Renal failure

            Ventricular tachycardia

            Syncope

            Heart block

            Torsades de pointes

            Potentially lethal arrhythmias: sustained polymorphic V-Tach (Torsades de Pointes), AV block

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            Warnings

            Black Box Warnings

            May cause potentially fatal arrhythmias, particularly sustained polymorphic ventricular tachycardia usually in association with QT prolongation (torsades de pointes), but sometimes without documented QT prolongation

            Studies show arrhythmias requiring cardioversion occurred in 1.7% of treated patients during or within a number of hours of using ibutilide fumarate; these arrhythmias can be reversed if treated promptly

            Administer in with continuous ECG monitoring & by personnel trained in identification and treatment of acute ventricular arrhythmias, particularly polymorphic ventricular tachycardia

            Patients with atrial fibrillation >2-3 days' duration must be adequately anticoagulated, generally for at least 2 wk

            Patients with chronic atrial fibrillation have a strong tendency to revert after conversion to sinus rhythm and treatment to maintain sinus rhythms carry risks; patients to be treated with this drug, should be carefully selected such that the expected benefits of maintaining sinus rhythm outweigh immediate risks of this medication, and the risks of maintenance therapy, and are likely to offer an advantage compared with alternative management

            Contraindications

            Hypersensitivity to drug or excipients

            Cautions

            Administer in a setting of continuous ECG monitoring and by personnel trained in treating arrhythmias such as polymorphic ventricular tachycardia

            Monitor for heart block

            The potential for proarrhythmia may increase with administration of this drug to patients who are being treated with drugs that prolong the QT interval, such as phenothiazines, tricyclic antidepressants, tetracyclic antidepressants, and certain antihistamine drugs (H1 receptor antagonists)

            Proarrhythmia

            • Like other antiarrhythmic agents, this medication can induce or worsen ventricular arrhythmias in some patients; this may have potentially fatal consequences
            • Torsades de pointes, a polymorphic ventricular tachycardia that develops in the setting of a prolonged QT interval, may occur because of the effect this drug has on cardiac repolarization, but the drug can also cause polymorphic VT in the absence of excessive prolongation of the QT interval
            • In general, with drugs that prolong the QT interval, the risk of torsades de pointes is thought to increase progressively as the QT interval is prolonged and may be worsened with bradycardia, a varying heart rate, and hypokalemia
            • Proarrhythmic events must be anticipated; skilled personnel and proper equipment, including cardiac monitoring equipment, intracardiac pacing facilities, a cardioverter/defibrillator, and medication for treatment of sustained ventricular tachycardia, including polymorphic ventricular tachycardia, must be available during and after administration of this drug
            • Before treatment hypokalemia and hypomagnesemia should be corrected to reduce the potential for proarrhythmia; patients should be observed with continuous ECG monitoring for at least 4 hours following infusion or until QTc has returned to baseline
            • Longer monitoring is required if any arrhythmic activity is noted; management of polymorphic ventricular tachycardia includes discontinuation of therapy, correction of electrolyte abnormalities, especially potassium and magnesium, and overdrive cardiac pacing, electrical cardioversion, or defibrillation
            • Pharmacologic therapies include magnesium sulfate infusions; treatment with antiarrhythmics should generally be avoided

            Antiarrhythmics

            • Class Ia antiarrhythmic drugs (Vaughan Williams Classification), such as disopyramide, quinidine, and procainamide, and other class III drugs, such as amiodarone and sotalol, should not be given concomitantly with this medication or within 4 hours postinfusion because of their potential to prolong refractoriness
            • In the clinical trials, class I or other class III antiarrhythmic agents were withheld for at least 5 half-lives prior to ibutilide infusion and for 4 hours after dosing, but thereafter were allowed at the physician's discretion
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            Pregnancy & Lactation

            Pregnancy

            This drug should not be administered to a pregnant woman unless clinical benefit outweighs potential risk to fetus

            Ibutilide administered orally was teratogenic (abnormalities included adactyly, interventricular septal defects, and scoliosis) and embryocidal in reproduction studies in rats

            On mg/m2 basis, corrected for 3% oral bioavailability, the "no adverse effect dose" (5 mg/kg/day given orally) was approximately the same as the maximum recommended human dose (MRHD); the teratogenic dose (20 mg/kg/day given orally) was about four times the MRHD on mg/m2 basis, or 16 times the MRHD on mg/kg basis

            Lactation

            The excretion of ibutilide into breast milk has not been studied; accordingly, breastfeeding should be discouraged during therapy with this drug

            Pregnancy Categories

            A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA: Information not available.

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            Pharmacology

            Mechanism of Action

            Prolongs action potential duration and increase both atrial and ventricular refractoriness (class III effects)

            Markedly prolongs action potential and repolarization

            Pharmacokinetics

            Half-Life: 2-12 hr

            Onset: 90 min following infusion

            Duration: 24 hr

            Protein Bound: 40%

            Vd: 11 L/kg

            Metabolism: Liver via oxidation

            Metabolites: Hydroxy derivative (active)

            Excretion: Urine (82%); feces (20%)

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            Administration

            IV Compatibilities

            Solution: D5W, NS

            IV Preparation

            Dilute in 50 mL NS or D5W to make 0.017 mg/mL solution

            IV Administration

            IV infusion over 10 min diluted or undiluted

            Storage

            May store diluted soln for 24 hr at room temperature OR 48 hr at 2-8°C (36-46°F)

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            Images

            BRAND FORM. UNIT PRICE PILL IMAGE
            ibutilide fumarate intravenous
            -
            0.1 mg/mL vial
            Corvert intravenous
            -
            0.1 mg/mL vial
            Corvert intravenous
            -
            0.1 mg/mL vial

            Copyright © 2010 First DataBank, Inc.

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            Patient Handout

            Patient Education
            ibutilide fumarate intravenous

            NO MONOGRAPH AVAILABLE AT THIS TIME

            USES: Consult your pharmacist.

            HOW TO USE: Consult your pharmacist.

            SIDE EFFECTS: Consult your pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

            PRECAUTIONS: Consult your pharmacist.

            DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

            OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

            NOTES: No monograph available at this time.

            MISSED DOSE: Consult your pharmacist.

            STORAGE: Consult your pharmacist.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

            Information last revised July 2016. Copyright(c) 2023 First Databank, Inc.

            IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.