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Eptifibatide

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Eptifibatide, Integrilin

  • See Also
  1. Glycoprotein IIB/IIIA Inhibitor
  2. Abciximab
  3. Tirofiban
  • Indications
  1. Non-Q-Wave Myocardial Infarction
  2. High risk Unstable Angina
  3. Percutaneous Coronary Intervention (PCI)
  • Contraindications
  1. Recent major bleeding (last 30 days)
  2. Hemodialysis
  3. Bleeding Diathesis
  4. Severe Hypertension (systolic Blood Pressure >200/110 mmHg)
  5. Prior Hemorrhagic Stroke
  • Mechanism
  1. Inhibits Platelet aggregation via Glycoprotein IIb/IIIa receptors on Platelet plasma membranes
  2. Inhibits Fibrinogen binding to Platelets
  • Dosing
  1. General
    1. Typically administered with Heparin and Aspirin
  2. Acute Coronary Syndrome
    1. Load: 180 mcg/kg IV bolus
    2. Infuse: 2 mcg/kg/min IV for up to 72 hours
  3. Percutaneous Coronary Intervention (PCI)
    1. Bolus 180 mcg/kg IV immediately before procedure and again 10 minutes after the first dose
    2. Infuse: 2 mcg/kg/min IV for 18 to 24 hours after procedure (at least 12 hours)
  4. Renal Impairment (GFR<50 ml/min)
    1. Decrease infusion rate to 1 mcg/kg/min
  5. Obesity (weight >121 kg)
    1. Maximum bolus dose: 22.6 mg
    2. Maximum infusion rate 15 mg/hour (7.5 mg/hour if GFR<50 ml/min)
  • Adverse Effects
  1. Major Bleeding
  2. Thrombocytopenia
    1. Discontinue if Platelet Count drops to <100,000 Platelets/mm3
  • Safety
  1. Pregnancy Category B
  2. Unknown safety in Lactation
  • Resources
  1. Eptifibatide
    1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=f48ecd1e-a2c3-45d1-9e2e-d9a8fb71a770
  • References
  1. Bansal (2023) Eptifibatide, Treasure Island, StatPearls
    1. https://www.ncbi.nlm.nih.gov/books/NBK541066/
  2. Hamilton (2020) Tarascon Pocket Pharmacopoeia