Adult Dosing

Hereditary angioedema attacks

• Give 30 mg (3 mL) SC as three 10 mg (1 mL) injections
• If the attack persists, give additional 30 mg within 24 hrs

• Ecallantide must be administered by healthcare professionals (HCPs) with appropriate medical support to manage hereditary angioedema and anaphylactic reactions
• Different injection sites or the same anatomical location may be used for all three injections; site rotation is not necessary
• Injection sites should be at least 2 inches apart and away from the site of attack

Pediatric Dosing

• Safety and effectiveness in pediatric patients <16 yrs have not been established

Hereditary angioedema attacks

>16 yrs

• Give 30 mg (3 mL) SC as three 10 mg (1 mL) injections
• If the attack persists, give additional 30 mg within 24 hrs

• Ecallantide must be administered by HCPs with appropriate medical support to manage hereditary angioedema and anaphylactic reactions
• Different injection sites or the same anatomical location may be used for all three injections; site rotation is not necessary
• Injection sites should be at least 2 inches apart and away from the site of attack

[Outline]

• Adult Dosing
• Pediatric Dosing

• Treatment of acute attacks of hereditary angioedema (HAE) in patients 16 yrs of age

• Hypersensitivity to any of the ingredients of the product

• Anaphylaxis has been reported with the use of ecallantide. The drug should be administered by HCPs with appropriate medical support to manage hereditary angioedema (HAE) and anaphylactic reactions
• HCPs should be able to identify the similarity in symptoms between hereditary angioedema and hypersensitivity reactions and patients should be monitored appropriately
• Ecallantide should not be given to patients with known history of hypersensitivity to this drug

Renal Dose Adjustment

• Renal impairment: Dose adjustments not defined

Hepatic Dose Adjustment

• Hepatic impairment: Dose adjustments not defined

• Potentially serious hypersensitivity reactions such as anaphylaxis, manifested as chest discomfort, flushing, pharyngeal edema, pruritus, rhinorrhea, sneezing, nasal congestion, throat irritation, urticaria, wheezing and hypotension, have been reported with the use of ecallantide [US Black Box Warning]
• Hypersensitivity reactions usually occur within one hour of drug administration; closely monitor patients for an appropriate period of time following ecallantide administration
• HCPs should be aware of the similarity in acute HAE symptoms and hypersensitivity reactions; closely observe patients in the event of a hypersensitivity reaction [US Black Box Warning]
• Use of ecallantide should be avoided in patients with known clinical hypersensitivity to the drug [US Black Box Warning]

Caution: Use cautiously in

• Elderly patients

Pregnancy Category:C

Breastfeeding: It is unknown if ecallantide is excreted in breast milk. Manufacturer advises caution if administered to nursing women.

• CNS: Headache
• GI: Nausea, diarrhea, vomiting, upper abdominal pain
• DERM: Pruritus
• EENT: Nasopharyngitis
• RESP: Upper respiratory tract infection
• LOCAL: Injection site reactions
• IMMU: Hypersensitivity reactions, anaphylaxis
• MISC: Fatigue, pyrexia

• Human plasma kallikrein inhibitor; selectively binds to plasma kallikrein and blocks its binding site, thereby inhibiting the conversion of high molecular weight kininogen to bradykinin
• Metabolism: Unknown; CYP450: Unknown
• Renally excreted
• Half-life: 1.5-2.5 hrs

US Trade Name(s)

• Kalbitor

US Availability

Kalbitor

• INJ: 10 mg/mL

Canadian Trade Name(s)

• N/A

Canadian Availability

• N/A

UK Trade Name(s)

• N/A

UK Availability

• N/A

Australian Trade Name(s)

• N/A

Australian Availability

• N/A

[Outline]

Allergy & Immunology

Antiangioedema Agents

Kallikrein Inhibitors