ibutilide fumarate Nursing Considerations & Management

Drug Name

Generic Name :  ibutilide fumarate

Brand Name: Corvert

Classification: Antiarrhythmic (predominately class III)

Pregnancy Category C 

Dosage & Route
ADULTS > 60 KG (132 LB)
  • 1 vial (1 mg) infused over 10 min; may be repeated after 10 min if arrhythmia is not terminated.
  • 0.1 mL/kg (0.01 mg/kg) infused over 10 min; may be repeated after 10 min if arrhythmia is not terminated.
  • Not recommended.
Therapeutic actions
  • Ibutilide is a methanesulfonanilide derivative class III antiarrhythmic agent. It prolongs repolarisation and refractoriness without affecting conduction. Antiarrhythmic action may result from activation of slow, inward current (predominantly sodium) at very low concentrations.
  • Rapid conversion of atrial fibrillation or flutter of recent onset to sinus rhythm; most effective in arrhythmias of < 90 days’ duration
Adverse effects
  • Heart block, hypotension, hypertension, bradycardia, palpitations; headache; nausea, vomiting.
  • Potentially Fatal: Arrhythmias (including torsade de pointes).
  • Lactation. QTc interval >440 msec.
Nursing considerations
  • 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
  • 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.
  • WARNING: 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.
  • BLACK BOX WARNING: Keep emergency equipment readily available during and for at least 4 hr after administration; can cause potentially life-threatening arrhythmias.
  • 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 intravenous infusion. You will need ECG monitoring during and for 4 hours after administration.
  • Arrange for follow-up medical evaluation, including an ECG, which is important to monitor the effect of the drug on your heart.
  • You may experience these side effects: Rapid or irregular heartbeat (usually passes shortly), headache.
  • Report chest pain, difficulty breathing, numbness or tingling.