Eptifibatide

Indications

Eptifibatide is used for: Myocardial infarction, Unstable angina, Angioplasty, Percutaneous coronary intervention (PCI)

Adult Dose

Intravenous Unstable angina Adult: 180 mcg/kg via IV inj followed by 2 mcg/kg per minute by IV infusion for up to 72 hr. If percutaneous coronary intervention (PCI) is performed during therapy, infusion should be continued for 18-24 hr after procedure, up to a maximum total duration of 96 hr of therapy. Angioplasty Adult: Initially, 180 mcg/kg via IV inj, to be given immediately before procedure, followed by 2 mcg/kg/minute via IV infusion. A second dose of 180 mcg/kg via IV inj should be given 10 minutes after the 1st dose. Continue infusion until hospital discharge or for up to 18-24 hr (minimum treatment duration: 12 hr).

Child Dose

Renal Dose

Renal Impairment (CrCl <50 mL/min) ACS: 180 mcg/kg IV, THEN continuous infusion 1 mcg/kg/min PCI: 180 mcg/kg IV, THEN continuous infusion 1 mcg/kg/min with another 180 mcg/kg IV bolus 10 minutes after 1st one Hemodialysis: Safety and using during hemodialysis not established

Administration

Contra Indications

Active bleeding, increased risk of haemorrhage including hemorrhagic disorders, cerebrovascular disorders, history of stroke, uncontrolled hypertension, severe trauma, severe renal impairment, recent major surgery. Lactation.

Precautions

Discontinue in case of serious uncontrolled bleeding, or if emergency surgery or thrombolytic therapy is required. Hepatic impairment, platelet counts <100,000 mm3; hemorrhagic retinopathy, drugs affecting haemostasis. Check APTT or ACT prior to sheath removal. Severe renal impairment, vasculitis, haemorrhagic retinopathy, acute pericarditis or aortic dissection. Pregnancy. Lactation: excretion in milk unknown; use with caution

Pregnancy-Lactation

Pregnancy Category: B Lactation: excretion in milk unknown; use with caution

Interactions

Increased risk of bleeding w/ heparin, other anticoagulants, antiplatelet & thrombolytic agents.

Adverse Effects

Side effects of Eptifibatide : 1-10% Bleeding (8%), Hypotension (7%), Thrombocytopenia (2.3%), Injection site reaction <1% Hypersensitivity, Intracranial hemorrhage, Pulmonary hemorrhage, Thrombocytopenia, GI hemorrhage

Mechanism of Action

Eptifibatide is a cyclic heptapeptide which blocks the platelet glycoprotein IIb/IIIa receptor thus preventing platelet aggregation and thrombosis.