Eptifibatide

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Generic Name of Eptifibatide - Learn More

Eptifibatide

Eptifibatide Precaution - What You Need to Know

Eptifibatide is a glycoprotein IIb/IIIa inhibitor used in the management of acute coronary syndromes (ACS) and during percutaneous coronary interventions (PCI). Precautions must be taken in patients with a history of bleeding disorders, as the drug significantly increases the risk of bleeding. This includes patients with thrombocytopenia, active bleeding, or recent surgery (especially vascular or cardiac surgery). Eptifibatide should be used with caution in patients with a history of stroke, particularly those who have had a hemorrhagic stroke, as it may increase the risk of intracranial bleeding.

In patients with renal impairment, dose adjustments are required, as the drug is primarily cleared through the kidneys. Careful monitoring of renal function is recommended. Additionally, patients who are pregnant or breastfeeding should only use eptifibatide if the potential benefits outweigh the risks, as there is limited data on its safety in pregnancy. Monitoring of platelet count is essential, especially during the initial stages of treatment, as thrombocytopenia is a known adverse effect. Regular monitoring of bleeding and hematologic parameters is critical to ensure safe administration.

Eptifibatide Indication - Uses and Benefits

Eptifibatide is indicated for use in the treatment of acute coronary syndromes (ACS), particularly in patients who have not undergone coronary artery bypass grafting (CABG). It is commonly used in cases of non-ST-segment elevation myocardial infarction (NSTEMI) and unstable angina. The drug is also employed during percutaneous coronary intervention (PCI), where it helps to reduce thrombotic events by inhibiting platelet aggregation.

Eptifibatide is administered intravenously in a hospital setting and is often used in conjunction with other antiplatelet therapy, such as aspirin and heparin, to reduce the risk of further ischemic events. It plays a significant role in preventing thrombus formation and improving outcomes in patients with unstable coronary artery disease. Off-label, eptifibatide may be used in some cases of acute ischemic stroke or in patients with certain types of thrombosis, although this is less common and not routinely recommended.

Eptifibatide Contraindications - Important Warnings

Eptifibatide is contraindicated in patients with active bleeding, including those with gastrointestinal, genitourinary, or intracranial hemorrhage. It is also contraindicated in patients who have had a recent stroke, especially a hemorrhagic stroke, as the drug can exacerbate the risk of further bleeding. Other contraindications include patients with severe thrombocytopenia (platelet count less than 100,000 cells/mm³), as eptifibatide increases the risk of bleeding, which may be worsened by low platelet levels.

Patients who have recently undergone major surgery (including cardiovascular or vascular procedures) or trauma should avoid eptifibatide, as the drug can interfere with clot formation and exacerbate bleeding risks. Additionally, eptifibatide should not be used in patients with known hypersensitivity to the drug or its components. During pregnancy, the drug should only be used if the benefit justifies the potential risk, and it is contraindicated during breastfeeding due to the lack of safety data.

Eptifibatide Side Effects - What to Expect

Common side effects of eptifibatide include bleeding, which is the most significant and potentially dangerous adverse effect. This may present as bruising, epistaxis (nosebleeds), gastrointestinal bleeding, or, more rarely, intracranial hemorrhage. Other common side effects include thrombocytopenia (low platelet count), hypotension (low blood pressure), and allergic reactions such as rash or fever.

Serious side effects, though less common, include life-threatening bleeding events, such as gastrointestinal or intracranial hemorrhage, which require immediate discontinuation of the drug and medical intervention. In rare cases, patients may experience arrhythmias, particularly when the drug is administered during PCI procedures. Hypersensitivity reactions may manifest as difficulty breathing, swelling, or anaphylaxis, though these are very rare.

To mitigate side effects, healthcare providers should monitor platelet counts, renal function, and signs of bleeding regularly. If major bleeding or severe thrombocytopenia occurs, eptifibatide should be discontinued, and appropriate interventions, such as blood transfusion or platelet transfusion, may be necessary.

Eptifibatide Pregnancy Category ID - Safety Information

2

Eptifibatide Mode of Action - How It Works

Eptifibatide is a reversible inhibitor of the glycoprotein IIb/IIIa receptor, which is crucial for platelet aggregation. By blocking this receptor, eptifibatide prevents fibrinogen and other adhesive molecules from binding to platelets, thereby inhibiting platelet aggregation and thrombus formation. This action reduces the likelihood of clot formation, which is especially important in acute coronary syndrome and during PCI procedures where the risk of thrombosis is high.

The pharmacokinetics of eptifibatide show that it is rapidly absorbed when administered intravenously, with an onset of action within minutes. It has a short half-life, which allows for flexible titration during treatment. It is primarily excreted via the kidneys, and dose adjustments are necessary for patients with renal impairment. By inhibiting the final common pathway of platelet aggregation, eptifibatide is effective in preventing ischemic events associated with coronary artery disease and PCI.

Eptifibatide Drug Interactions - What to Avoid

Eptifibatide interacts with other anticoagulants and antiplatelet agents, increasing the risk of bleeding complications. When used in combination with other drugs such as heparin, warfarin, or clopidogrel, the risk of bleeding is elevated. Therefore, careful monitoring of coagulation parameters, including activated partial thromboplastin time (aPTT), is crucial when using these medications concurrently.

Eptifibatide should also be used cautiously with other drugs that affect platelet function or clotting, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or selective serotonin reuptake inhibitors (SSRIs), as they may further increase bleeding risks. Drugs that affect renal function may also alter the pharmacokinetics of eptifibatide, requiring dosage adjustments. In patients with renal impairment, lower doses of eptifibatide may be necessary to prevent accumulation and reduce the risk of bleeding complications.

Alcohol and lifestyle factors such as smoking may not have direct interactions with eptifibatide but should be addressed in the overall management of cardiovascular health. Alcohol use can further complicate bleeding risks, and smoking may exacerbate the underlying condition being treated, increasing the chances of cardiovascular events.

Eptifibatide Adult Dose - Recommended Dosage

For adults with acute coronary syndrome or during percutaneous coronary interventions, the usual initial dose of eptifibatide is 180 mcg/kg, administered as an intravenous bolus. Following the bolus, the maintenance dose is typically 2 mcg/kg/min, continued for up to 72 hours or until the procedure is completed. In patients with renal impairment (creatinine clearance <50 mL/min), the dose should be reduced to 1 mcg/kg/min for maintenance infusion.

Eptifibatide is typically given in a hospital setting where the patient can be closely monitored for any adverse reactions, including bleeding and thrombocytopenia. The duration of therapy depends on the patient's condition and clinical response but is typically limited to a few days. The exact dosing schedule may be modified based on individual clinical factors, such as renal function and response to treatment.

Eptifibatide Child Dose - Dosage for Children

Eptifibatide is not approved for use in pediatric patients, as there is insufficient data on its safety and efficacy in children. Its use is generally limited to adults with acute coronary syndrome and those undergoing percutaneous coronary interventions. If eptifibatide were to be considered in a pediatric setting, it would require careful, individualized dosing and close monitoring by a pediatric cardiologist, particularly because the pharmacodynamics and pharmacokinetics of the drug may differ in children compared to adults.

Eptifibatide Renal Dose - Dosage for Kidney Conditions

For patients with renal impairment, the dose of eptifibatide must be adjusted to account for reduced renal clearance. In patients with moderate to severe renal dysfunction (creatinine clearance <50 mL/min), the recommended maintenance dose is reduced to 1 mcg/kg/min to prevent drug accumulation and reduce the risk of bleeding complications. In patients with end-stage renal disease (ESRD) undergoing dialysis, further adjustments may be required, and eptifibatide should only be used with careful monitoring.

Close monitoring of renal function is essential during therapy with eptifibatide, and renal function should be assessed regularly. If renal function deteriorates during treatment, the dose of eptifibatide should be reduced further, or the drug should be discontinued if clinically appropriate.