Eptifibatide

Eptifibatide is used to reduce the risk of acute cardiac ischemic events (death and/or myocardial infarction) in patients with unstable angina or non-ST-segment-elevation (e.g., non-Q-wave) myocardial infarction (i.e., non-ST-segment elevation acute coronary syndromes) both in patients who are to receive non surgery.

glycoprotein 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 percutaneous coronary intervention (PCI). For the treatment of patients undergoing PCI, including those undergoing intracoronary stenting.

In combination with aspirin and unfractionated heparin for the prevention of early myocardial infarction in patients with unstable angina or non-ST-segmentelevation myocardial infarction and with last episode of chest pain within 24 hours (specialist use only) INITIALLY BY INTRAVENOUS INJECTION Adult: Initially 180 micrograms/kg, then (by intravenous infusion) 2 micrograms/kg/minute for up to 72 hours (up to 96 hours if percutaneous coronary intervention during treatment).

In various clinical studies, eptifibatide was used concomitantly with unfractionated heparin and aspirin. In another study, clopidogrel or ticlopidine were used routinely starting the day of PCI. Because eptifibatide inhibits platelet aggregation, caution should be employed when it is used with other drugs that affect hemostasis, including thrombolytics, oral anticoagulants, NSAIDS and dipyridamole. To avoid potentially additive pharmacologic effects, concomitant treatment with other inhibitors of platelet receptor GP IIb/IIIa should be avoided. Enoxaparin did not alter the pharmacokinetics of Eptifibatide.

Abnormal bleeding within 30 days . aneurysm . arteriovenous malformation . haemorrhagic diathesis . history of haemorrhagic stroke . increased INR. increased prothrombin time . intracranial disease . major surgery or severe trauma within 6 weeks . neoplasm . severe hypertension . stroke within last 30 days . thrombocytopenia. Discontinue if emergency cardiac surgery necessary . discontinue if intra-aortic balloon pump necessary . discontinue if thrombolytic therapy necessary . risk of bleeding?discontinue immediately if uncontrolled serious bleeding.

Common or very common Bleeding manifestations Very rare Anaphylaxis . Rash

PREGNANCY Manufacturer advises use only if potential benefit outweighs risk?no information available. BREAST FEEDING Manufacturer advises avoid?no information available.

There has been only limited experience with overdosage of Eptifibatide. Symptoms of acute toxicity were loss of righting reflex, dyspnea, ptosis, and decreased muscle tone in rabbits, and petechial hemorrhages in the femoral and abdominal areas of monkeys. From in vitro studies, eptifibatide is not extensively bound to plasma proteins and thus may be cleared from plasma by dialysis.

Vials should be stored refrigerated at 2-8°C. Vials may be transferred to room temperature storage for up to 2 months. Unused portion left in the vial should be discarded. Vials should be protected from light until administration.