Dosing & Uses
Dosage Forms & Strengths
injection solution
- 2mg/mL
- 0.75mg/mL
Acute Coronary Syndromes
180 mcg/kg IV bolus over 1-2 min, THEN
2 mcg/kg/min IV continuous infusion; continue infusion until hospital discharge or initiation of coronary artery bypass graft surgery (CABG), up to 72 hours
Patient to undergo PCI: infusion should be continued until hospital discharge or for up to 18- 24 hr after procedure, whichever comes first, allowing for up to 96 hr of therapy
Administer aspirin (160-325 mg) daily
Dosing considerations
- Administer concomitantly with heparin dosed to achieve the following parameters:
-
During medical management
- Target aPTT 50 - 70 seconds
- If weight greater than or equal to 70 kg, 5000-unit bolus followed by infusion of 1000 units/h
- If weight less than 70 kg, 60-units/kg bolus followed by infusion of 12 units/kg/h
-
During PCI
- Target ACT 200 to 300 seconds
- If heparin is initiated prior to PCI, additional boluses during PCI to maintain an ACT target of
- 200 to 300 seconds.
- Heparin infusion after the PCI is discouraged
-
Percutaneous Coronary Intervention
180 mcg/kg IV bolus immediately, THEN
Continuous infusion 2 mcg/kg/min with another 180 mcg/kg IV bolus 10 minutes after 1st bolus
Continue infusion until hospital discharge, or for up to 18 to 24 hours, whichever comes first; minimum 12 hr infusion recommended
In patients who undergo CABG surgery, drug infusion should be discontinued prior to surgery
Administer aspirin, 160 to 325 mg, 1 to 24 hours prior to PCI and daily thereafter
-
Dosing considerations
- Administer concomitantly with heparin to achieve a target ACT of 200 to 300 seconds
- Administer 60-units/kg bolus initially in patients not treated with heparin within 6 hours prior to PCI.
- Additional boluses during PCI to maintain ACT within target.
- Heparin infusion after the PCI is strongly discouraged
Discontinue administration in patients requiring thrombolytic therapy
Renal Impairment
(CrCl <50 mL/min)
ACS: 180 mcg/kg IV bolus as soon as possible, THEN continuous infusion 1 mcg/kg/min
PCI: 180 mcg/kg IV immediately before PCI, THEN continuous infusion 1 mcg/kg/min with another 180 mcg/kg IV bolus 10 minutes after 1st bolus
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
Interactions
Interaction Checker
No Results

Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor

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)
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 bleeding is the most common complication; minimize use of arterial and venous punctures, intramuscular injections, and use of urinary catheters, nasotracheal intubation, and nasogastric tubes; when obtaining intravenous access, avoid non-compressible sites (eg, subclavian or jugular veins)
- Risk factors for bleeding include older age, a history of bleeding disorders, and concomitant use of drugs that increase risk of bleeding (thrombolytics, oral anticoagulants, nonsteroidal anti-inflammatory drugs, and P2Y12 inhibitors); concomitant treatment with other inhibitors of platelet receptor glycoprotein (GP) IIb/IIIa should be avoided; in patients treated with heparin, bleeding can be minimized by close monitoring of aPTT and ACT
- In patients undergoing PCI, treatment may increase in major and minor bleeding at site of arterial sheath placement; after PCI, infusion should be continued until hospital discharge or up to 18 - 24 hours, whichever comes first;
- Heparin use is discouraged after PCI procedure; early sheath removal is encouraged while drug is being infused; prior to removing the sheath, it is recommended that heparin be discontinued for 3 to 4 hours and an aPTT of <45 seconds or ACT <150 seconds be achieved; in any case, both drugs should be discontinued and sheath hemostasis achieved at least 2 to 4 hours before hospital discharge; if bleeding at access site cannot be controlled with pressure, infusion of both drugs should be discontinued immediately
Thrombocytopenia
- There have been reports of acute, profound thrombocytopenia (immune-mediated and non-immune mediated); in the event of acute profound thrombocytopenia or a confirmed platelet decrease to <100,000/mm3, discontinue drug and heparin (unfractionated or low-molecular weight); monitor serial platelet counts, assess presence of drug-dependent antibodies, and treat as appropriate
- There has been no clinical experience with therapy initiated in patients with a baseline platelet count <100,000/mm3; if a patient with low platelet counts is receiving drug, their platelet count should be monitored closely
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.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
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
Inspect for particulate matter and discoloration prior to administration, whenever solution and container permit
May administer in the same intravenous line as alteplase, atropine, dobutamine, heparin, lidocaine, meperidine, metoprolol, midazolam, morphine, nitroglycerin, or verapamil
Do not administer through the same intravenous line as furosemide
May administer in the same IV line with 0.9% NaCl or 0.9% NaCl/5% dextrose; with either vehicle, the infusion may also contain up to 60 mEq/L of potassium chloride
Withdraw bolus dose(s) from the 10-mL vial into a syringe; administer bolus dose(s) by IV push
Immediately following bolus dose administration, initiate a continuous infusion
When using an intravenous infusion pump, administer undiluted directly from 100-mL vial
Spike the 100-mL vial with a vented infusion set; center the spike within the circle on the stopper top
Discard any unused portion left in the vial
Images
Patient Handout
Formulary
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.