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 &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :832

%Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :25

%Excreted unchanged in urine &nbsp &nbsp : 50

Volume of distribution (L/kg) &nbsp &nbsp &nbsp :0.185–0.26

half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :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 &nbsp &nbsp &nbsp &nbsp &nbsp : Reduce infusion to 1 mcg/kg/minute and use with caution due to limited experience

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Unknown dialysability. Dose as in GFR <10 mL/min

HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Dialysed. Dose as in GFR

<10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL/min

HDF/high flux &nbsp :Dialysed. Dose as in GFR

<10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL/min

CAV/VVHD &nbsp &nbsp &nbsp: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

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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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