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eptifibatide (Rx)Brand and Other Names:Integrilin

 
 
 

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

injection solution

  • 2mg/mL
  • 0.75mg
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Acute Coronary Syndromes

180 mcg/kg IV bolus over 1-2 min, THEN 

2 mcg/kg/min IV for up to 72 hr

Percutaneous Coronary Intervention

180 mcg/kg IV, THEN 

Continuous infusion 2 mcg/kg/min with another 180 mcg/kg IV bolus 10 minutes after 1st one

Continue infusion for at least 12 hours

Renal Impairment

(CrCl <50 mL/min)

ACS: 180 mcg/kg IV, THEN continuous infusion 1 mcg/kg/min 

PCI: 180 mcg/kg IV, THEN continuous infusion 1 mcg/kg/min with another 180 mcg/kg IV bolus 10 minutes after 1st one

Hemodialysis: Safety and using during hemodialysis not established

Safety & efficacy not established

In clinical trials, incidence of bleeding complications was higher in the elderly in both placebo and eptifibatide groups, and the incremental risk of eptifibatide-associated bleeding was greater in the older patients. Adjust dose to renal function

Acute Coronary Syndromes

180 mcg/kg IV bolus over 1-2 min, THEN 

2 mcg/kg/min IV for up to 72 hr

Percutaneous Coronary Intervention

180 mcg/kg IV, THEN

Continuous infusion 2 mcg/kg/min with another 180 mcg/kg IV bolus 10 minutes after 1st one

Continue infusion for at least 12 hours

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Interactions

Interaction Checker

eptifibatide and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            1-10%

            Bleeding (8%)

            Hypotension (7%)

            Thrombocytopenia (2.3%)

            Injection site reaction

            <1%

            Hypersensitivity

            Intracranial hemorrhage

            Pulmonary hemorrhage

            Thrombocytopenia

            GI hemorrhage

            Postmarketing Reports

            Immune-mediated thrombocytopenia (thought to be caused by antibodies that react with GP IIb/IIIa complex)

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            Warnings

            Contraindications

            Hypersensitivity

            History of internal bleeding, intracranial hemorrhage or neoplasm, CVA, thrombocytopenia

            AV malformation or aneurysm, aortic dissection, severe HTN, acute pericarditis

            Other parenteral glycoprotein IIb/IIIa inhibitors

            Cautions

            Bleeding at the site of arterial sheath placement is the most common complication

            Early sheath removal is encouraged while eptifibatide is being infused; prior to removing the sheath, it is recommended that heparin be discontinued for 3-4 hr and an aPTT of <45 seconds or ACT <150 seconds be achieved

            Thrombocytopenia: Discontinue if platelet levels <100,000 mm/cu.mm

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            Pregnancy & Lactation

            Pregnancy Category: B

            Lactation: excretion in milk unknown; use with caution

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Blocks binding of fibrinogen and von Willebrand factor to glycoprotein IIb/IIIa receptor on platelet surface

            Pharmacokinetics

            Half-life, elimination: 2.5 hr

            Onset: 1 hr

            Duration: 4 hr

            Protein bound: 25%

            Vd: 185-260 mL/kg

            Metabolites: Deaminated eptifibatide, other more polar metabolites detected in urine, no metabolites detected in plasma

            Clearance: 55-58 mL/kg/hr

            Excretion: Urine

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            Administration

            IV Incompatibilities

            Y-site, additive, syringe: furosemide

            IV Compatibilities

            Y-site: alteplase, amiodarone, atropine, bivalirudin, dobutamine, heparin, lidocaine, meperidine, metoprolol, midazolam, morphine sulfate, nitroglycerin, verapamil

            IV Preparation

            Bolus injection: withdraw from 10 mL vial (2 mg/mL; 10, 100 mL)

            Infusion: no prep needed; spike 100 ml vial with vented infusion set (0.75 mg/mL; 100 mL)

            IV Administration

            Bolus: administer undiluted over 1-2 min

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            Images

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            Formulary

            FormularyPatient Discounts

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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