Tirofiban
Anticoagulant/Antiplatelet · Antiplatelet
Indications
Prevention of early MI in patients with unstable angina or non-Q-wave MI with last episode of chest pain within 12 hours and with ECG changes and/or elevated cardiac enzymes. To be used with aspirin and unfractionated heparin, under specialist supervision.
Dosage
Adults: Initially 0.4 mcg/kg per min by IV infusion for 30 min starting within 12 hr of the last anginal episode. Then, 0.1 mcg/kg per min by IV infusion for at least 48 hr; max treatment period 108 hr. Children: Not recommended.
Administration
IV: Infuse over 30 min. Tirofiban injection must be diluted to a concentration of 50 mcg/mL (premixed solution does not require dilution). Unused solution should be discarded. Do not administer via the same IV line as diazepam. Compatibility: Stable in D5 ½NS, D5W, NS. Tirofiban may be administered in the same IV line as dopamine, lidocaine, potassium chloride and famotidine injection. Tirofiban and heparin can be administered through the same IV catheter. Incompatible with diazepam. Stability: Store at 25°C (77°F). Do not freeze. Protect from light during storage.
Adverse Effects
Bleeding, GI. Post-operative pulmonary, intracranial or retroperitoneal bleeding, haemopericardium, epidural haematoma, epistaxis, gum bleeds, surface dermatorrhagia, bleeding from catheter sites, decrease in platelet counts. Nausea, fever, headache, rash, severe allergic reactions.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: History of stroke, haemorrhagic stroke, haemorrhage within last 30 days, history of intracranial disease, malignant hypertension, trauma or major surgery within last 6 weeks, thrombocytopenia, platelet function disorders, clotting disturbances, severe liver failure. Precautions: Severe renal failure, protracted cardiopulmonary resuscitation, organ biopsy or lithotripsy within last 2 weeks, severe trauma or major surgery 6-12 weeks previously, active peptic ulcer within 3 months, uncontrolled hypertension, acute pericarditis, vasculitis, aortic dissection, haemorrhagic retinopathy, haematuria, occult blood in stools, significant bleeding within last year, recent epidural, severe acute or chronic heart failure, cardiogenic shock, mild to moderate liver impairment, anaemia. Female,…
Interactions
Thrombolytics within last 48 hours, anticoagulants and other GPIIb/IIIa inhibitors, LMWH's, ticlopidine, clopidogrel, adenosine, dipyridamole, sulfinpyrazone, prostacyclin, dextran solutions and diazepam infusion.
Advice to Patient
Contact prescriber if there is unusual bleeding or bruising; unusual and persistent fever; dizziness; vision changes; headache; swelling; back, leg or pelvic pain or persistent nausea; vomiting. There is a tendency of easy bleeding. To prevent bleeding, use soft toothbrush or cotton swabs, floss with waxed floss, use electric razor, avoid scissors or sharp knives and harmful activities. If bleeding occurs, apply pressure to bleeding spot until bleeding stops completely.
Pharmacokinetics
Onset: >90% inhibition of platelet aggregation (reversible after discontinuation) seen within 10 min. Metabolism: Negligible. Half-life elimination: 2 hrs. Excretion: Urine (65%). Faeces (25%).
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
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