Tirofiban Disease Interactions

The use of gp11b/111a platelet inhibitors is contraindicated in patients with active internal bleeding, recent significant gastrointestinal or genitourinary bleeding (within 6 weeks), recent trauma or major surgery (within 6 weeks), history of bleeding diathesis, recent stroke (within 4 weeks), history of hemorrhage stroke or residual neurologic deficit, intracranial defect (aneurysm, arteriovenous malformation, neoplasm), uncontrolled hypertension (SBP > 180; DBP > 110), or thrombocytopenia (<100,000/mm3). Thrombocytopenia, serious GI/GU bleeding, hemorrhagic retinopathy, and bleeding at the arterial access have been reported during gp11b/111a platelet inhibitor therapy. Clinical monitoring of hemoglobin and hematocrit (H/H), platelet count, prothrombin time (PT) and activated partial prothrombin time (aPTT) is recommended prior to initiation of, during and following gp11b/111a platelet inhibitor therapy.

Tirofiban is primarily eliminated by the kidney. Approximately 65% of tirofiban is excreted in the urine, largely unchanged. The serum concentration of tirofiban is significantly increased (>50%) in patients with a creatinine clearance <30 mL/min (including hemodialysis patients). Therapy with tirofiban should be administered cautiously and initiated at a reduced dosage in patients with severe renal impairment. Clinical monitoring of renal function and bleeding activity is recommended. Tirofiban is removed by dialysis.