ibutilide fumarate

(eye byu' ti lyed)

Corvert

Pregnancy Category C

Drug class
Antiarrhythmic (predominately class III)

Therapeutic actions
Prolongs cardiac action potential, increases atrial and ventricular refractoriness; produces
mild slowing of sinus rate and AV conduction.

Indications
• Rapid conversion of atrial fibrillation or flutter of recent onset to sinus rhythm;
most effective in arrhythmias of < 90 days' duration

Contraindications and cautions

• Contraindicated with hypersensitivity to ibutilide; second- or third-degree AV
heart block, prolonged QTc intervals.
• Use cautiously with ventricular arrhythmias, pregnancy, lactation, renal and
hepatic impairment.

Available forms
Solution—0.1 mg/mL

Dosages
ADULTS
< 60 kg: 0.1 mL/kg (0.01 mg/kg) infused over 10 min; may be repeated after 10 min if
arrhythmia is not terminated.
> 60 kg (132 lb): 1 vial (1 mg) infused over 10 min; may be repeated after 10 min if
arrhythmia is not terminated.
PEDIATRIC PATIENTS
Not recommended.

Pharmacokinetics
Route Onset Peak
IV Immediate 10 min

Metabolism: Hepatic; T1/2: 6 hr

Distribution: Crosses placenta, may be excreted in breast milk
Excretion: Urine and feces

IV facts
Preparation: May be diluted in 50 mL of diluent, 0.9% sodium chloride, or 5% dextrose
injection; one 10-mL vial added to 50 mL of diluent yields a concentration of
0.017 mg/mL; may also be infused undiluted; diluted solution is stable for 24 hr at room
temperature or for 48 hr refrigerated.
Infusion: Infuse slowly over 10 min.
Compatibilities: Compatible with 5% dextrose injection, 0.9% sodium chloride
injection.
Incompatibilities: Do not mix in solution with any other drugs.

Adverse effects
• CNS: Headache, light-headedness, dizziness, tingling in arms, numbness
• CV: Ventricular arrhythmias, hypotension, hypertension
• GI: Nausea

Interactions
Drug-drug
• Increased risk of serious to life-threatening arrhythmias with disopyramide,
quinidine, procainamide, amiodarone, sotalol; do not give together
• Increased risk of proarrhythmias with phenothiazines, TCAs, antihistamines
• Use cautiously with digoxin because ibutilide may mask digoxin cardiotoxicity

Nursing considerations
Assessment
• History: Hypersensitivity to ibutilide; second- or third-degree AV heart block,
time of onset of atrial arrhythmia; prolonged QTc intervals; pregnancy, lactation;
ventricular arrhythmias
• Physical: Orientation; BP, P, auscultation, ECG; R, adventitious sounds

Interventions
• Determine time of onset of arrhythmia and potential benefit before beginning
therapy. Conversion is more likely in patients with arrhythmias of short (< 90
days') duration.
• Ensure that patient is adequately anticoagulated, generally for at least 2 wk, if
atrial fibrillation lasts > 2–3 days.
• Monitor ECG continually during and for at least 4 hr after administration. Be alert
for possible arrhythmias, including PVCs, sinus tachycardia, sinus bradycardia,
varying degrees of block at time of conversion.
• Keep emergency equipment readily available during and for at least 4 hr after
administration.
• Provide appointments for continued follow-up, including ECG monitoring;
tendency to revert to atrial arrhythmia after conversion increases with length of
time patient was in abnormal rhythm.

Teaching points
• This drug can only be given by IV infusion. You will need ECG monitoring
during and for 4 hours after administration.
 • Arrange for follow-up medical evaluation, including ECG, which is important to
monitor the effect of the drug on your heart.
• These side effects may occur: Rapid or irregular heartbeat (usually passes
shortly), headache.
• Report chest pain, difficulty breathing, numbness or tingling.

Adverse effects in Italic are most common; those in Bold are life-threatening.