Ibutilide
CORVERT
What it isClass III hERG potassium-channel blocker; acute conversion of atrial flutter and fibrillation.
Why this oneIt converts atrial flutter more reliably than atrial fibrillation and acts rapidly by infusion.
What limits itPotentially fatal torsades requires continuous ECG observation after dosing with magnesium and resuscitation capability available.
FDA-approved for
- atrial fibrillation (IV) (1995)
FDA label
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| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Atrial fibrillation/flutter (conversion to sinus rhythm) | ≥60 kg | 1 mg (one vial) IV over 10 min | 1 mg IV over 10 min | |
| Atrial fibrillation/flutter | <60 kg | 0.01 mg/kg (0.1 mL/kg) IV over 10 min | 0.01 mg/kg IV over 10 min |
Renal Undefined
Hepatic Undefined
May repeat same dose once, 10 min after completion of first infusion, if arrhythmia persists
Instructions
- May give undiluted or diluted in 50 mL (0.9% NaCl or 5% dextrose)
- Continuous ECG monitoring during and ≥4 h after infusion (or until QTc returns to baseline)
- Have cardioverter/defibrillator and treatment for sustained/polymorphic VT available
- Stop infusion when arrhythmia terminates or if sustained/nonsustained VT or marked QT/QTc prolongation
Available strengths
- inj 0.1 mg/mL
Cautions
- Proarrhythmia — potentially fatal polymorphic ventricular tachycardia (Torsades)
- QT/QTc prolongation
- Requires continuous ECG monitoring and resuscitation equipment
Adverse reactions
- Sustained/nonsustained polymorphic VT
- Monomorphic VT
- Ventricular/supraventricular extrasystoles
- AV block, bundle branch block
- Hypotension
- Bradycardia/tachycardia
- QT prolongation
- Nausea
- Headache
Pregnancy Teratogenic and embryocidal in rats; give only if benefit outweighs fetal risk
Lactation Undefined
Cost
Ibutilide (CORVERT)
| Strength | #/mo | generic $/unit | CostPlus | |
|---|---|---|---|---|
| 0.1 mg/mL | inj | per unit | not offered |
NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. Ibutilide is administered under clinical supervision and dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.
⚠ BOXED WARNING
- Potentially fatal arrhythmias including torsades
Classes and tags
Clinical profile
Defining liabilityAcute torsades and other life-threatening ventricular arrhythmias