Eptifibatide is eliminated via renal excretion, so dose adjustment is recommended with a creatinine clearance of less than 50 mlmin 2,64. Eptifibatide is available in 100ml vials containing either 0. Eptifibatide side effects, dosage, interactions drugs. Safety and efficacy of adjusteddose eptifibatide in patients. Nov 09, 2018 eptifibatide is injected into a vein through an iv.
Drug dosing in renal insufficiency needs to be individualized whenever possible to optimize therapeutic outcomes and to minimize toxicity. Clearance in patients with coronary artery disease is about 55 mlkgh. Integrilin eptifibatide side effects, images, uses, dosage. What is the most important information i should know about eptifibatide integrilin.
No major metabolites have been detected in human plasma. Pharmacologic evaluations of eptifibatide in animal models and in humans have demonstrated a rapid onset of action, short plasma halflife, and rapid clearance from plasma. Eptifibatide is a platelet aggregation inhibitor that prevents plateletsspecialized blood cellsfrom sticking together and clotting. Adult drugs analgesics antihypertensive and cardiovascular agents antimicrobial agents miscellaneous. Highlights of prescribing information coadministration of. Includes dosages for myocardial infarction, angina pectoris, acute coronary syndrome and more.
In clinical trials, incidence of bleeding complications was higher in the elderly in both placebo and eptifibatide groups, and the incremental risk of eptifibatideassociated bleeding was greater in the older patients. Inspect integrilin for particulate matter and discoloration prior to administration, whenever solution and container permit. Integrilin eptifibatide dosing, indications, interactions. Nov 01, 2019 integrilin should be given concomitantly with heparin dosed to achieve the following parameters.
Eptifibatide dosage needs to be adjusted in renal impairment. Eptifibatide is an antiplatelet drug which reversibly binds and inhibits glycoprotein. Donovan jl1, schroeder ws, tran mt, foster k, forrest a, lee tb, gandhi pj. Although a number of published tables that provide dosing gu. In healthy subjects, renal clearance accounts for approximately 50% of total body clearance, with the majority of the drug excreted in the urine as eptifibatide, deaminated eptifibatide, and other. If weight greater than or equal to 70 kg, 5000unit bolus followed by infusion of unitsh. Effient prasugrel dose, indications, adverse effects. Eptifibatide is eliminated via renal excretion, so dose adjustment is.
Although contraindicated in dialysis patients due to limited safety and. Munar, pharmd, bcps, and harleen singh, pharmd oregon state university college of pharmacy, portland, oregon. Administer integrilinby volume according to patient weightsee table1. Renal dosage adjustment guidelines for antimicrobials the pharmacists will automatically adjust the doses of any of the antimicrobials included in the protocol according to the estimated creatinine clearance generally using the cockroftgault equation for patients. Withdraw the bolus dose s of integrilinfrom the 10ml vial into a syringe. Continue heparin or enoxaparin, continue eptifibatide.
Guidelines for the use of eptifibatide integrilin in. Integrilin etifibatide injection etifibatide injection. A catalogue record for this book is available from the british library. Eptifibatide injection integrilin side effects, medical.
Eptifibatide is injected into a vein through an iv. Integrilin should be given concomitantly with heparin dosed to achieve the following. Integrilin eptifibatide uses, side effects, dosage. Integrilin eptifibatide dose, indications, adverse. If you are receiving this injection during an angioplasty procedure, the medicine will be given throughout the entire procedure and for up to 24 hours after the procedure. Withdraw bolus dose of eptifibatide from the 10 ml vial into a syringe. When administered alone, eptifibatide has no measurable effect on pt or aptt. Renal drug handbook 3rd edition general intensive care unit. Drug dosing adjustments in patients with chronic kidney disease. Renal dosage adjustment guidelines for antimicrobials.
Read more about the prescription drug eptifibatide injection. Eptifibatide is a cyclic heptapeptide derived from a disintegrin protein found in the venom of the southeastern pygmy rattlesnake sistrurus miliarius barbouri. Continue eptifibatide for at least 1824 hours after the procedure. Inspect eptifibatide for particulate matter and discoloration prior to administration, whenever solution and container permit. Center the spike within the circle on the stopper top. Novel dosing regimen of eptifibatide in planned coronary stent implantation esprit. In patients with moderate renal impairment creatinine clearance.
Esprit was a randomized, placebocontrolled trial that evaluated the use of eptifibatide in elective pci. When using an intravenous infusion pump, administer integrilin undiluted directly from the 100ml vial. Detailed eptifibatide dosage information for adults. Assessment of eptifibatide dosing in renal impairment before and after inservice education provided by pharmacists. Assessment of eptifibatide clearance by hemodialysis using an in. The level of renal function below which the dose of a drug must be reduced depends largely on the extent of renal metabolism and elimination, and on the drugs toxicity. May administer eptifibatide in the same intravenous line as alteplase, atropine, dobutamine, heparin, lidocaine, meperidine, metoprolol, midazolam, morphine, nitroglycerin, or verapamil. Eptifibatide should not be used in patients with renal failure and is contraindicated in patients with dependency on renal dialysis. Only if clinically necessary, restart iv heparin or sq enoxaparin 4 hours after sheath removal. Clinical pharmacology of eptifibatide sciencedirect. Dosing guidelines book school of medicine university of.
Adult drugs analgesics antihypertensive and cardiovascular agents antimicrobial agents miscellaneous agents sedatives, hypnotics, and other drugs used in. The information on dosage adjustments in renal impairment given in this book is. Drug dosing in renal insufficiency talbert 1994 the. It belongs to the class of the argininglycinaspartatmimetics and reversibly binds to platelets. Use of eptifibatide is considered contraindicated in patients who are dependent on renal dialysis. Eptifibatide definition of eptifibatide by medical dictionary. Aug 26, 2019 although there has been no clinical experience on the use of eptifibatide in patients on dialysis, in vitro studies suggest it is not extensively bound to plasma proteins and thus may be cleared from plasma by dialysis. This book is distributed under the terms of the creative commons. What are the possible side effects of eptifibatide integrilin. Assessment of eptifibatide dosing in renal impairment before. Withdraw the bolus doses of integrilin from the 10ml vial into a syringe. The present study was designed to assess teh pharmacokinetic and pharmacodynamic properties of eptifibatide in subjects with various levels of creatinine clearance crcl, a parameter that is a.
Drug dosing adjustments in patients with chronic kidney disease myrna y. The authors explore efficacy and safety outcomes in multiple degrees of renal impairment when using fdaapproved dosing regimens for enoxaparin and find that a more multitiered dosing strategy appears to be needed. Consumer information about the medication eptifibatide injection integrilin, includes side effects, drug interactions, recommended dosages, and storage information. Immediately following the bolus dose administration, initiate a continuous infusion of integrilin. In healthy subjects, renal clearance accounts for approximately 50% of total body clearance, with the majority of the drug excreted in the urine as eptifibatide, deaminated eptifibatide, and other, more polar metabolites. Dec 29, 2019 the eptifibatide dosing regimen used in the esprit study included two 180mcgkg bolus doses given 10 minutes apart combined with a continuous 2mcgkgmin infusion. Enabling research by provision of chemical tools poster the tocris chemistry team has considerable chemistry knowledge and skill which it has recently been applying to the generation of new chemical probes from known tools and compounds to help answer biological questions. The dosing regimens are designed to provide simplicity of administration. Guidelines for the use of eptifibatide integrilin in acute. Safety and efficacy of adjusteddose eptifibatide in patients with acute coronary syndromes and reduced renal function. Integrilin eptifibatide dose, indications, adverse effects.
Drug dosing adjustments in patients with chronic kidney. Eptifibatide supplier cas 188627807 tocris bioscience. Dailymed integrilin eptifibatide injection, solution. Find patient medical information for eptifibatide intravenous on webmd including its uses, side effects and safety, interactions, pictures, warnings and user ratings. Eptifibatide reference guide for safe and effective use from the american. Eptifibatide has been evaluated in acute coronary syndromes, extracorporeal bypass, and in normal human volunteers. Pediatric drugs analgesics antihypertensive and cardiovascular agents antimicrobial agents miscellaneous agents sedatives, hypnotics, and other drugs used in psychiatry. A model of dosing agreement among various methods of estimating creatinine clearance article pdf available in annals of pharmacotherapy 464. Eptifibatide accord is intended for use with acetylsalicylic acid and unfractionated heparin. Eptifibatide is an antiplatelet drug of the glycoprotein iibiiia inhibitor class. Integrilin, inneptifibatide european medicines agency.
See renal impairment under dosage and administration. What should i discuss with my health care provider before receiving eptifibatide integrilin. Ptt seconds dosing adjustment for heparin infusion check ptt less than 40 increase rate by 2 ml per hour 6 hours 41 to 49 increase rate by 1 ml per hour 6 hours 50 to 70 maintain rate, at goal next a. Pediatric drugs analgesics antihypertensive and cardiovascular agents antimicrobial agents. The renal drug handbook third edition edited by caroline ashley and aileen currie uk renal pharmacy group foreword by dr aine burns radcliffe publishing. Baxters cardiovascular medicine eptifibatide approved by fda drugs targeting arterial thrombi include the antiplatelet drugs aspirin, clopidogrel, abciximab, eptifibatide and tirofiban and the fibrinolytics. Proceed to complete the diagnostic cardiac catheterization. Renal functionbased dose adjustments adult inpatient. Eptifibatide is sometimes given around the clock for up to 4 days in a row. Renal dosing modifications are intended to maximize outcomes through the establishment and maintenance of therapeutic drug concentrations, and minimize toxicity that may result from excessive accumulation of the drug or its metabolites. Novel dosing regimen of eptifibatide in planned coronary.
910 379 152 117 616 74 816 686 94 974 1393 146 640 500 911 1446 1506 1163 1268 452 1222 363 334 196 1631 22 1068 826 1285 806 48 344 580 456 1117 616 166 1341