Eptifibatide

Eptifibatide is a blood thinner which prevents formation of harmful blood clots. It is used in the treatment of a heart attack and also prevents the clotting of blood in the heart during an angioplasty (procedure to improve blood flow to the heart).

Eptifibatide is administered under the supervision of a doctor. Your doctor will decide the dose and duration of the medicine for you. You should continue all your other medicines that are advised by the doctor for your long-term treatment even after this injection.

Eptifibatide is an antiplatelet medication. It works by preventing the platelets from sticking together, thereby decreasing the formation of harmful blood clots.

• Acute Coronary Syndrome (Unstable Angina/NSTEMI): Indicated for patients to be managed medically and those undergoing PCI.
• Percutaneous Coronary Intervention (PCI): Indicated for patients undergoing PCI, including those undergoing intracoronary stenting.

Anti-platelet drugs

GP IIb/IIIa Inhibitor

Eptifibatide is indicated for the treatment of patients with acute coronary syndrome (unstable angina/non-ST-segment elevation myocardial infarction), including patients who are to be managed medically and those undergoing PCI. For the treatment of patients undergoing PCI, including those undergoing intracoronary stenting.

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

Adult Dose (Normal Renal Function):

• Acute Coronary Syndrome: 180 mcg/kg IV bolus, THEN 2 mcg/kg/min IV infusion for up to 72 hr.
• PCI: 180 mcg/kg IV bolus (before procedure), THEN 2 mcg/kg/min IV infusion; second 180 mcg/kg IV bolus 10 min after first.

Renal Dose (CrCl <50 mL/min):

• ACS: 180 mcg/kg IV bolus, THEN 1 mcg/kg/min IV infusion.
• PCI: 180 mcg/kg IV bolus, THEN 1 mcg/kg/min IV infusion; second 180 mcg/kg IV bolus 10 min after first.

Your doctor or nurse will give you this medicine. Kindly do not self administer. Eptifibatide is administered as an IV infusion.

If you miss a dose of Eptifibatide, please consult your doctor.

Common Side Effects:

• Bleeding (mostly at femoral artery access site)
• Decreased blood pressure
• Intracranial hemorrhage and stroke (rare)
• Thrombocytopenia
• Allergic reactions

Precautions:

• Eptifibatide is intended for use in hospitalized patients.
• It is usually given by your nurse or doctor as an infusion (drip) into a vein.
• It increases your risk of bleeding. Be careful while shaving, cutting fingernails or toenails or using sharp objects.
• Notify your doctor if you see blood in your vomit, urine or stool.
• In patients undergoing PCI, there is an increase in bleeding at the site of arterial sheath placement.
• Caution in patients with platelet count <100,000/mm³.
• Avoid use with other GP IIb-IIIa inhibitors.

Contraindications:

• Active bleeding
• History of bleeding diathesis or cerebrovascular disorders
• History of stroke within 30 days or hemorrhagic stroke
• Uncontrolled hypertension (SBP >200 mm Hg or DBP >110 mm Hg)
• Severe renal impairment (dialysis dependency)
• Major surgery within preceding 6 weeks
• Lactation
• Hypersensitivity

Drug Interactions:

• Increased risk of bleeding with heparin, other anticoagulants, antiplatelet & thrombolytic agents.
• Caution with thrombolytics, oral anticoagulants, NSAIDs and dipyridamole.
• Avoid concomitant use with other GP IIb/IIIa inhibitors.

Food Interactions: It is not known whether it is safe to consume alcohol with Eptifibatide. Consult your doctor.

Use in Pregnancy: Category B. Animal studies revealed no evidence of harm to the fetus. However, no adequate and well-controlled studies in pregnant women. Should be used only if clearly needed.

Use in Lactation: It is not known whether Eptifibatide is excreted in human milk. Use with caution. Breastfeeding should be held until treatment is completed and drug is eliminated from the body.

Pediatric Use: Safety and effectiveness in pediatric patients have not been established.

Geriatric Use: No specific dosage adjustment is necessary for elderly patients.

Renal Impairment: Use with caution. CrCl <50 mL/min: Reduce dose to 1 mcg/kg/min. Not recommended in patients with severe kidney disease.

Hepatic Impairment: Limited information available. Not recommended in patients with severe liver disease.

Overdose: Limited experience with overdosage. In animal studies, symptoms included: loss of righting reflex, dyspnea, ptosis, decreased muscle tone, and petechial hemorrhages. Eptifibatide is not extensively bound to plasma proteins and may be cleared by dialysis.

Storage: Vials should be stored refrigerated at 2-8°C. Vials may be transferred to room temperature for up to 2 months. Protect from light until administration.

Eptifibatide