Dosing & Uses
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
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
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.
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
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
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.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%)
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)
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.
Patient Handout
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.
Formulary
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.
