Eptifibatide

CLINICAL USE

Antiplatelet agent:Prevention of early myocardial infarction in patients with unstable angina or non-ST segment-elevation myocardial infarction and with last episode of chest pain within 24 hours

DOSE IN NORMAL RENAL FUNCTION

IV bolus of 180 mcg/kg then by

IV infusion

at a rate of 2 mcg/kg/minute for up to 72–96 hours

PHARMACOKINETICS

  • Molecular weight                           :832
  • %Protein binding                           :25
  • %Excreted unchanged in urine     : 50
  • Volume of distribution (L/kg)       :0.185–0.26
  • half-life – normal/ESRD (hrs)      :2.5/Increased

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

    30–50 Reduce infusion to 1 mcg/kg/minute and use with caution due to limited experience10–30 Reduce infusion to 1 mcg/kg/minute and use with caution due to limited experience

  • <10           : Reduce infusion to 1 mcg/kg/minute and use with caution due to limited experience

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :Unknown dialysability. Dose as in GFR <10 mL/min
  • HD                     :Dialysed. Dose as in GFR
  • <10           : mL/min
  • HDF/high flux   :Dialysed. Dose as in GFR
  • <10           : mL/min
  • CAV/VVHD      :Unknown dialysability. Dose as in GFR=10–30 mL/min

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugsIloprost: increased risk of bleeding

    ADMINISTRATION

    Reconstition

    –

    Route

    IV bolus,

    IV infusion

    Rate of Administration

    1–2 mcg/kg/minute depending on renal function

    Comments

    –

    OTHER INFORMATION

    Antiplatelet effect lasts for about 4 hours after stopping infusionMain side effect is bleeding In patients with a GFR<50 mL/min, clearance is halved and plasma concentration doubled.

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