Integrilin Dosage
Generic name: eptifibatide
Dosage form: injection
This dosage information does not include all the information needed to use Integrilin safely and effectively. See full prescribing information for Integrilin.
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The safety and efficacy of eptifibatide has been established in clinical studies that employed concomitant use of heparin and aspirin. Different dose regimens of eptifibatide were used in the major clinical studies (see CLINICAL STUDIES).
Acute Coronary Syndrome
The recommended adult dosage of eptifibatide in patients with acute coronary syndrome and normal renal function is an intravenous bolus of 180 mcg/kg as soon as possible following diagnosis, followed by a continuous infusion of 2.0 mcg/kg/min until hospital discharge or initiation of CABG surgery, up to 72 hours. If a patient is to undergo a percutaneous coronary intervention (PCI) while receiving eptifibatide, the infusion should be continued up to hospital discharge, or for up to 18 to 24 hours after the procedure, whichever comes first, allowing for up to 96 hours of therapy.
Non-Dialysis Dependent Patients With Creatinine Clearance Less Than 50 mL/min
The recommended adult dosage of eptifibatide in patients with acute coronary syndrome with an estimated creatinine clearance (using the Cockcroft-Gault equation)1 <50 mL/min is an intravenous bolus of 180 mcg/kg as soon as possible following diagnosis, immediately followed by a continuous infusion of 1.0 mcg/kg/min.
Percutaneous Coronary Intervention (PCI)
The recommended adult dosage of eptifibatide in patients with normal renal function is an intravenous bolus of 180 mcg/kg administered immediately before the initiation of PCI followed by a continuous infusion of 2.0 mcg/kg/min and a second 180-mcg/kg bolus 10 minutes after the first bolus. Infusion should be continued until hospital discharge, or for up to 18 to 24 hours, whichever comes first. A minimum of 12 hours of infusion is recommended.
Non-Dialysis Dependent Patients With Creatinine Clearance Less Than 50 mL/min
The recommended adult dose of eptifibatide in patients with an estimated creatinine clearance (using the Cockcroft-Gault equation)1 <50 mL/min is an intravenous bolus of 180 mcg/kg administered immediately before the initiation of the procedure, immediately followed by a continuous infusion of 1.0 mcg/kg/min and a second 180-mcg/kg bolus administered 10 minutes after the first.
In patients who undergo coronary artery bypass graft surgery, eptifibatide infusion should be discontinued prior to surgery.
- 1
- Use the Cockcroft-Gault equation with actual body weight to calculate creatinine clearance:
Males: (140 – age) × (actual body wt in kg) Females: (140 – age) × (actual body wt in kg) × 0.85 72 × (serum creatinine) 72 × (serum creatinine)
Aspirin and Heparin Dosing Recommendations
In the clinical trials that showed eptifibatide to be effective, most patients received concomitant aspirin and heparin. The recommended aspirin and heparin doses to be used are as follows:
Acute Coronary Syndrome
Heparin
Target aPTT 50 to 70 seconds during medical management
- If weight ≥70 kg, 5000-U bolus followed by infusion of 1000 U/hr.
- If weight <70 kg, 60-U/kg bolus followed by infusion of 12 U/kg/hr.
Target ACT 200 to 300 seconds during PCI
- 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.
PCI
Heparin
Target ACT 200 to 300 seconds
- 60-U/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.
Patients requiring thrombolytic therapy should have eptifibatide infusions stopped.
