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Eptifibatide

Classification

Antiplatelet

Glycoprotein IIb/IIIa inhibitor

Indications

CCP: Acute coronary syndrome

Contraindications

Hypersensitivity
Bleeding diathesis history
Active abnormal bleeding within 30 days
Major surgery within 6 weeks
Hemorrhagic stroke history
Platelet count < 100 000
Systolic pressure > 200, Diastolic > 110
Dialysis patients

Cautions

CrCl < 50
Elderly patients

Adult dosages

CCP: Acute coronary syndrome

Loading dose: 180 mcg/kg IV bolus over 1-2 minutes
Maintenance: 2 mcg/kg/min IV infusion
Renal adjustment: Loading dose remains the same. Maintenance dose is reduced to 1 mcg/kg/min

Pediatric Considerations And Dosing

Currently unavailable as safety has not been established.

Mechanism Of Action

Reversibly binds to platelet glycoprotein IIb/IIIa reducing platelet aggregation and preventing thrombosis.

Pharmacokinetics

Onset: Immediate

Duration: 4-8 hours

Half-life: 2.5 hours

Adverse Effects

Hematologic

Hemorrhage
Thrombocytopenia

Cardiovascular

Hypotension

Local

Injection site reaction

Neurological

Cerebrovascular accident
Intracranial hemorrhage

Warning And Precautions

The most common complication is bleeding. Patients < 70 kg may be at a greater risk of bleeding.
Use with caution in patients with renal dysfunction (estimated CrCl <50 mL/minute, using Cockcroft-Gault equation); dosage adjustment required. Use is contraindicated in patients dependent upon hemodialysis.
It is not known if eptifibatide is present in breast milk. If present in breast milk, eptifibatide is expected to be destroyed in the infant GI tract and not be orally absorbed via breastfeeding.
Information related to eptifibatide use in pregnancy is limited. Myocardial infarction is a medical emergency and maternal treatment should not be withheld because of fears of teratogenicity.

Drug Interactions

Acalabrutinib
Agents with Antiplatelet Properties (e.g., P2Y12 inhibitors, NSAIDs, SSRIs, etc.)
Anticoagulants
Apixaban
Bemiparin
Cephalothin
Collagenase (Systemic)
Dabigatran Etexilate
Dasatinib
Deoxycholic Acid
Edoxaban
Enoxaparin
Glucosamine
Heparin
Herbs (Anticoagulant/Antiplatelet Properties) (eg, Alfalfa, Anise, Bilberry)
Ibritumomab Tiuxetan
Ibrutinib
Icosapent Ethyl
Inotersen
Lipid Emulsion (Fish Oil Based)
Multivitamins/Fluoride (with ADE)
Multivitamins/Minerals (with ADEK, Folate, Iron)
Multivitamins/Minerals (with AE, No Iron)
Obinutuzumab
Omega-3 Fatty Acids
Pentosan Polysulfate Sodium
Pentoxifylline
Prostacyclin Analogues
Rivaroxaban
Salicylates
Selumetinib
Thrombolytic Agents
Urokinase
Vitamin E (Systemic)
Zanubrutinib