II. Indications
- Non-Q-Wave Myocardial Infarction
- High risk Unstable Angina
- Percutaneous Coronary Intervention (PCI)
III. Contraindications
- Recent major bleeding (last 30 days)
- Hemodialysis
- Bleeding Diathesis
- Severe Hypertension (systolic Blood Pressure >200/110 mmHg)
- Prior Hemorrhagic Stroke
IV. Mechanism
- Inhibits Platelet aggregation via Glycoprotein IIb/IIIa receptors on Platelet plasma membranes
- Inhibits Fibrinogen binding to Platelets
V. Dosing
- General
-
Acute Coronary Syndrome
- Load: 180 mcg/kg IV bolus
- Infuse: 2 mcg/kg/min IV for up to 72 hours
-
Percutaneous Coronary Intervention (PCI)
- Bolus 180 mcg/kg IV immediately before procedure and again 10 minutes after the first dose
- Infuse: 2 mcg/kg/min IV for 18 to 24 hours after procedure (at least 12 hours)
- Renal Impairment (GFR<50 ml/min)
- Decrease infusion rate to 1 mcg/kg/min
-
Obesity (weight >121 kg)
- Maximum bolus dose: 22.6 mg
- Maximum infusion rate 15 mg/hour (7.5 mg/hour if GFR<50 ml/min)
VI. Adverse Effects
- Major Bleeding
-
Thrombocytopenia
- Discontinue if Platelet Count drops to <100,000 Platelets/mm3
VII. Safety
- Pregnancy Category B
- Unknown safety in Lactation
VIII. Resources
IX. References
- Bansal (2023) Eptifibatide, Treasure Island, StatPearls
- Hamilton (2020) Tarascon Pocket Pharmacopoeia