Questions about Atrial Fibrillation? Get answers from our expert.

eptifibatide

Generic Name: eptifibatide (ep ti FYE ba tide)
Brand Name: Integrilin

What is eptifibatide?

Eptifibatide keeps the platelets in your blood from coagulating (clotting) to prevent unwanted blood clots that can occur with certain heart or blood vessel conditions.

Eptifibatide is used to prevent blood clots or heart attack in people with severe chest pain or other conditions, and in those who are undergoing a procedure called angioplasty (to open blocked arteries).

Eptifibatide may also be used for purposes not listed in this medication guide.

What is the most important information I should know about eptifibatide?

You should not receive this medication if you are allergic to eptifibatide, if you have or will soon receive treatment with similar medications such as abciximab (ReoPro) or tirofiban (Aggrastat).

You should not receive this medication if you have severe or uncontrolled high blood pressure, if you are on dialysis due to kidney failure, history of a bleeding or blood clotting disorder, if you had a stroke or any type of bleeding within the past 30 days, or if you had any type of surgery, injury, or medical emergency within the past 6 weeks.

Eptifibatide is not expected to be harmful to an unborn baby. However, aspirin is sometimes given with eptifibatide, and aspirin can cause bleeding when it is taken during the last 3 months of pregnancy. Aspirin can also cause side effects in a newborn baby.

Tell your doctor if you are pregnant or plan to become pregnant during treatment with eptifibatide and aspirin.

Because eptifibatide keeps your blood from coagulating (clotting) to prevent unwanted blood clots, it can also make it easier for you to bleed, even from a minor injury. Contact your doctor or seek emergency medical attention if you have bleeding that will not stop.

What should I discuss with my health care provider before receiving eptifibatide?

You should not receive this medication if you are allergic to eptifibatide, if you have or will soon receive treatment with similar medications such as abciximab (ReoPro) or tirofiban (Aggrastat), or if you have:

  • kidney failure and you are on dialysis;

  • severe or uncontrolled high blood pressure;

  • history of a bleeding or blood clotting disorder, such as hemophilia or thrombocytopenia;

  • if you have had a stroke or any type of bleeding within the past 30 days; or

  • if you have had any type of surgery, injury, or medical emergency within the past 6 weeks.

To make sure you can safely receive eptifibatide, tell your doctor if you have kidney disease.

FDA Pregnancy Category B. Eptifibatide is not expected to be harmful to an unborn baby. However, aspirin is sometimes given with eptifibatide, and aspirin can cause bleeding when it is taken during the last 3 months of pregnancy. Aspirin can also cause side effects in a newborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether eptifibatide passes into breast milk or if it could harm a nursing baby. Do not receive this medication without telling your doctor if you are breast-feeding a baby.

How is eptifibatide given?

Eptifibatide is injected into a vein through an IV. You will receive this injection in a clinic or hospital setting. Eptifibatide is sometimes given around the clock for up to 4 days in a row.

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.

Eptifibatide is sometimes given together with aspirin. Follow your doctor's instructions about how much aspirin to take and for how long.

To be sure this medicine is helping your condition and is not causing harmful effects, your blood will need to be tested often. Visit your doctor regularly.

Because eptifibatide keeps your blood from coagulating (clotting) to prevent unwanted blood clots, it can also make it easier for you to bleed, even from a minor injury. Contact your doctor or seek emergency medical attention if you have bleeding that will not stop.

What happens if I miss a dose?

Since eptifibatide is given by a healthcare professional, you are not likely to miss a dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include severe forms of some of the side effects listed in this medication guide.

What should I avoid while receiving eptifibatide?

Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.

Avoid drinking alcohol. It may increase your risk of bleeding in your stomach or intestines.

Eptifibatide side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

  • easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

  • blood in your urine;

  • black, bloody, or tarry stools;

  • coughing up blood or vomit that looks like coffee grounds;

  • any bleeding that will not stop;

  • sudden numbness or weakness, especially on one side of the body;

  • sudden severe headache, confusion, problems with vision, speech, or balance;

  • fever, chills, body aches, flu symptoms; or

  • feeling like you might pass out.

Less serious side effects may also occur, such as:

  • nausea;

  • upset stomach; or

  • bleeding around the IV needle.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Eptifibatide Dosing Information

Usual Adult Dose for Myocardial Infarction:

Initial: 180 mcg/kg intravenous bolus administered as soon as possible following diagnosis
Maintenance: 2 mcg/kg/min continuous infusion (following the initial bolus) 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.

In patients who undergo coronary artery bypass graft surgery, eptifibatide infusion should be discontinued prior to surgery.

Usual Adult Dose for Angina Pectoris:

Initial: 180 mcg/kg intravenous bolus administered as soon as possible following diagnosis
Maintenance: 2 mcg/kg/min continuous infusion (following the initial bolus) 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.

In patients who undergo coronary artery bypass graft surgery, eptifibatide infusion should be discontinued prior to surgery.

Usual Adult Dose for Acute Coronary Syndrome:

Initial: 180 mcg/kg intravenous bolus administered as soon as possible following diagnosis
Maintenance: 2 mcg/kg/min continuous infusion (following the initial bolus) 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.

In patients who undergo coronary artery bypass graft surgery, eptifibatide infusion should be discontinued prior to surgery.

Usual Adult Dose for Percutaneous Coronary Intervention:

Initial: 180 mcg/kg intravenous bolus administered immediately before the initiation of PCI followed by a continuous infusion of 2 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 by the manufacturer. Alternatively, an infusion duration of 16 hours may be appropriate as noted in the ESPRIT substudy.

In patients who undergo coronary artery bypass graft surgery, eptifibatide infusion should be discontinued prior to surgery.

What other drugs will affect eptifibatide?

Tell your doctor about all other medicines you use, especially:

  • a blood thinner such as warfarin (Coumadin, Jantoven), heparin, ardeparin (Normiflo), dalteparin (Fragmin), danaparoid (Orgaran), enoxaparin (Lovenox), fondaparinux (Arixtra), or tinzaparin (Innohep);

  • drugs that dissolve blood clots, such as alteplase (Activase), tenecteplase (TNKase), urokinase (Abbokinase);

  • medicines that keep blood platelets from clumping together, such as anagrelide (Agrylin), cilostazol (Pletal), clopidogrel (Plavix), dipyridamole (Persantine, Aggrenox), prasugrel (Effient), ticlopidine (Ticlid); or

  • medicines that block the action of a blood-clotting enzyme, such as argatroban (Acova), dabigatran (Pradaxa), bivalirudin (Angiomax), lepirudin (Refludan).

This list is not complete and other drugs may interact with eptifibatide. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about eptifibatide.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 2.01. Revision Date: 2011-05-15, 11:47:39 PM.

Hide
(web2)