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.
How Supplied
Not supplied by BCEHS
2 mg/ml
0.75 mg/ml
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