Ecallantide
Ecallantide is a kallikrein inhibitor used to treat acute attacks of hereditary angioedema (HAE) in patients aged 12 years and older with C1-esterase-inhibitor (C1-INH) deficiency. It is administered as a subcutaneous injection and works by inhibiting the enzyme kallikrein, which reduces the production of bradykinin—a key mediator responsible for swelling and inflammation in HAE attacks.
Ecallantide is an injectable medication for acute hereditary angioedema attacks that works by inhibiting kallikrein to reduce bradykinin-mediated swelling.
This medication carries a boxed (black box) warning — the strongest type of FDA warning. Review the full prescribing information before use.
Key facts at a glance
- ATC
- B06AC03
- RxNorm
- 658708
- Generic
- Ecallantide
- Class
- atc-b06
- Brands
- Kalbitor
- Availability
- rx
- Lactation
- unknown
- Routes
- —
- Forms
- injection
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 500mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 250mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 400mg daily
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
7 groupspregnancy
first trimesteravoid if possible
use only if clearly needed and benefits outweigh potential risks
regular fetal monitoring
Use with caution and monitor for adverse effects.
pregnancy
second third trimesteruse lowest effective dose
continue only if benefits outweigh risks
routine prenatal monitoring
Use with caution and monitor for adverse effects.
lactation
breastfeedingno adjustment recommended
decide whether to discontinue nursing or stop drug based on importance to mother
monitor infant for adverse effects
pediatric_age
adolescents 12 to 17same as adult dosing
approved for patients 12 years and older
standard monitoring for adverse reactions
geriatric
elderly 65 and olderno specific dose adjustment
use with caution due to limited clinical experience
monitor renal and hepatic function
Use with caution and monitor for adverse effects.
renal_impairment
moderate to severeno specific adjustment needed
use with caution; limited clinical data available
monitor renal function periodically
Use with caution and monitor for adverse effects.
hepatic_impairment
mild to moderateno specific adjustment needed
use with caution; limited clinical data available
monitor hepatic function periodically
Use with caution and monitor for adverse effects.
Statistics and clinical data
FDA approval year
FDA approval for acute hereditary angioedema treatment
Drug class
Proteinase inhibitor class
Common uses
Treatment of HAE in patients 12 years and older
Route of administration
Subcutaneous injection administration
Treatment of acute attacks of hereditary angioedema (HAE) in patients 12 years of age and older with C1-esterase-inhibitor (C1-INH) deficiency. It is specifically indicated for on-demand treatment of acute attacks and is not used for prophylactic therapy.
Ecallantide is a recombinant protein that directly inhibits kallikrein, a key enzyme in the kinin system. By blocking kallikrein, it prevents the conversion of kininogen to bradykinin, thereby reducing the vasodilation and increased vascular permeability that cause the swelling and pain characteristic of HAE attacks.
Ecallantide is administered as three subcutaneous injections (each 10 mg/mL) in the abdominal region. It carries a boxed warning for anaphylaxis, which has been observed in approximately 4% of patients in clinical trials. Healthcare providers should observe patients for at least one hour after administration. It is contraindicated in patients with known hypersensitivity to ecallantide or any of its components.
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed July 26, 2026. · Read our editorial policy