Eptifibatide

Eptifibatide is a prescription injectable used to treat patients:

• Experiencing acute chest pain or a heart attack OR
• Undergoing coronary catheterization.

Eptifibatide belongs to a family of drugs called glycoprotein (GP) IIb/IIIa inhibitors. Other members of this family are abciximab (ReoPro) and tirofiban (Aggrastat).

Eptifibatide is co-marketed as Integrilin by Millenium Pharmaceuticals and Schering-Plough.

Uses

Eptifibatide is specifically indicated for:

• The treatment of patients with acute coronary syndrome (acute chest pain due to reduced blood flow to the heart OR acute heart attack due to reduced/blocked blood flow to the heart)
• The treatment of patients undergoing percutaneous coronary intervention (PCI or coronary catheterization)

How Eptifibatide is Taken

In acute coronary syndrome (ACS)

The recommended adult dosage of eptifibatide in patients with ACS is an intravenous dose of 180 µg/kg immediately following diagnosis. This dose is followed by a continuous infusion of 2 µg/kg/min until hospital discharge or initiation of heart bypass surgery, up to 72 hours.

In percutaneous coronary intervention (PCI)

The recommended adult dosage of eptifibatide is an intravenous dose of 180 µg/kg administered immediately before the initiation of PCI followed by a continuous infusion of 2 µg/kg/min and a second 180-µg/kg dose 10 minutes after the first dose. Infusion should be continued until hospital discharge, or for up to 24 hours, whichever comes first. A minimum of 12 hours of infusion is recommended.

How Eptifibatide Works

The vast majority of heart attacks (acute MI's) are due to one primary underlying factor: the development of blood clots in the arteries feeding the heart. These blood clots prevent an adequate supply of blood from reaching the heart tissue, causing the heart tissue to decay and die.

Eptifibatide works by inhibiting the formation of these blood clots. It does so by preventing the binding of fibrinogen, von Willebrand factor, and other blood clotting factors to a protein called GP IIb/IIIa. This action inhibits platelet aggregation, a crucial step in the development of blood clots.

How the Body Affects Eptifibatide

Administration of a single 180-µg/kg dose combined with an infusion produces an early peak level, followed by a small decline prior to attaining steady state circulating levels at 4-6 hours post-dosing.

The majority of the drug is excreted in the urine as eptifibatide and its metabolites.

Side Effects

The only serious nonbleeding side effect that occurs in >1% of treated patients and is statistically attributable to Integrilin is hypotension (low blood pressure).

Risks and Precautions

Bleeding is the most common serious complication encountered during eptifibatide therapy. Administration of eptifibatide is associated with an increase in major and minor bleeding.

Most major bleeding associated with eptifibatide has been at the access site for cardiac catheterization or from the gastrointestinal or genitourinary tract.

Drug Interactions

Because eptifibatide inhibits blood clotting, it needs to be used cautiously with other drugs that affect blood clotting, including thrombolytics, oral anticoagulants, nonsteroidal anti-inflammatory drugs (NSAID's like aspirin), and dipyridamole.

Concurrent treatment with other GP IIb/IIIa inhibitors is not recommended.

Effectiveness

Eptifibatide is one of the most well studied drugs on the market and has been shown time and time again to be very effective at reducing rates of death and heart attacks.^[1]

References

1. ↑ O'Shea JC, Buller CE, Cantor WJ, et al. Long-term Efficacy of Platelet Glycoprotein IIb/IIIa Integrin Blockade With Eptifibatide in Coronary Stent Intervention. JAMA Vol. 287 No. 5, Feb 6, 2002. Abstract

External Links

FDA: Patient Information Sheet

Drugs.com

Rx List