Eptifibatide

Anticoagulant/Antiplatelet · Glycoprotein IIb/IIIA inhibitor

Indications

Prevention of early myocardial infarction in patients with unstable angina or non-Q-wave myocardial infarction with last episode of chest pain within 24 hours and with ECG changes and/or elevated cardiac enzymes. For use with aspirin and unfractionated heparin, under specialist supervision.

Dosage

Adults: Initially 180 mcg/kg by IV bolus inj, followed by 2 microgram/kg per min by continuous IV inf for up to 72 hr. If percutaneous coronary intervention is performed during therapy, continue infusion for 20-24 hr post-PCI for a total max duration of therapy of 96 hr. Children: Not recommended.

Administration

IV: Administer bolus doses by IV push over 1-2 min. Begin continuous infusion immediately following bolus administration; administer directly from the 100 mL vial. IV Detail: Visually inspect for discolouration or particulate matter prior to administrations. The bolus dose should be withdrawn from the 10 mL vial into a syringe. The 100 mL vial should be spiked with a vented infusion set. Compatibility: Compatible with alteplase, atropine, dobutamine, heparin, lidocaine, meperidine, metoprolol, midazolam, morphine, nitroglycerine, verapamil. 0.9% NaCl, NS/ D5W, KCl. Incompatible with Furosemide. Stability: Vial should be stored refrigerated at 2°C-8°C (36°F-46°F). Vial may be transferred to room temperature storage for a period not to exceed 2 months. Protect from light until administration. Discard any unused portion left in the vial. Store at controlled room temperature 25°C (77°F);…

Adverse Effects

Major and minor bleeding events, cardiovascular disturbances.

Risk Factor (Pregnancy/Lactation)

Pregnancy: No evidence of risk in humans. Lactation: Caution advised or effect undetermined. Contraindications: GI, genitourinary or other active abnormal bleeding within past 30 days. Stroke within past 30 days or history of haemorrhagic stroke. Intracranial disease. Major surgery or severe trauma within past 6 weeks. Thrombocytopenia, prothrombin time >1.2 times control or INR 2.0 or more. Severe hypertension. Severe renal or hepatic impairment. Precautions: Monitor for signs of bleeding. Monitor haematology before and during therapy. Stop immediately if thrombolytic therapy or emergency cardiac surgery required or if uncontrollable bleeding occurs. Stop if platelet count falls below 100,000 mm3. Renal or hepatic impairment.

Interactions

Other parenteral GPIIb/IIIa inhibitors. Thrombolytics, oral anticoagulants, LMWH's, dextrans, adenosine, sulfinpyrazone, prostacyclin, NSAIDs, dipyridamole, ticlopidine, clopidogrel, furosemide, streptokinase.

Advice to Patient

Contact prescriber immediately if there is unusual bruising or bleeding (blood in urine, stool, or vomitus, bleeding gums), dizziness, vision changes or back pain. Avoid activities that may lead to bruising and bleeding. If bleeding occurs, apply pressure to bleeding point until bleeding stops completely. Use soft toothbrush, electric razor. Avoid sharp things, needles, knives, scissors.

Pharmacokinetics

Onset: Immediate. Duration: 4-6 hrs post-infusion. Half-life elimination: 2.5 hrs. Time to peak: Immediate. Excretion: Urine.

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.