Eptifibatide injection integrilin side effects, medical. In healthy subjects, renal clearance accounts for approximately 50% of total body clearance, with the majority of the drug excreted in the urine as eptifibatide, deaminated eptifibatide, and other. Drug dosing adjustments in patients with chronic kidney disease. Immediately following the bolus dose administration, initiate a continuous infusion of integrilin. Safety and efficacy of adjusteddose eptifibatide in patients with acute coronary syndromes and reduced renal function. Renal functionbased dose adjustments adult inpatient. The authors explore efficacy and safety outcomes in multiple degrees of renal impairment when using fdaapproved dosing regimens for enoxaparin and find that a more multitiered dosing strategy appears to be needed. Continue eptifibatide for at least 1824 hours after the procedure. Drug dosing adjustments in patients with chronic kidney disease myrna y. Pediatric drugs analgesics antihypertensive and cardiovascular agents antimicrobial agents miscellaneous agents sedatives, hypnotics, and other drugs used in psychiatry. Elimination is both renal and extrarenal, and it is directly proportional to weight and inversely correlated with age. Renal dosage adjustment guidelines for antimicrobials the pharmacists will automatically adjust the doses of any of the antimicrobials included in the protocol according to the estimated creatinine clearance generally using the cockroftgault equation for patients. Eptifibatide is an antiplatelet drug of the glycoprotein iibiiia inhibitor class.
Inspect eptifibatide for particulate matter and discoloration prior to administration, whenever solution and container permit. Highlights of prescribing information coadministration of. It belongs to the class of the argininglycinaspartatmimetics and reversibly binds to platelets. Guidelines for the use of eptifibatide integrilin in. Clinical pharmacology of eptifibatide sciencedirect. Eptifibatide is available in 100ml vials containing either 0. The information on dosage adjustments in renal impairment given in this book is. Donovan jl1, schroeder ws, tran mt, foster k, forrest a, lee tb, gandhi pj. In patients with moderate renal impairment creatinine clearance. 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. A novel dosing regimen was suggested for eptifibatide in planned coronary stent implantation. Integrilin eptifibatide dose, indications, adverse. Eptifibatide is sometimes given around the clock for up to 4 days in a row.
Eptifibatide reference guide for safe and effective use from the american. Withdraw the bolus dose s of integrilinfrom the 10ml vial into a syringe. Read more about the prescription drug eptifibatide injection. Pdf adjusting eptifibatide doses for renal impairment. Eptifibatide accord is intended for use with acetylsalicylic acid and unfractionated heparin. Baxters cardiovascular medicine eptifibatide approved by fda drugs targeting arterial thrombi include the antiplatelet drugs aspirin, clopidogrel, abciximab, eptifibatide and tirofiban and the fibrinolytics. What should i discuss with my health care provider before receiving eptifibatide integrilin. Eptifibatide side effects, dosage, interactions drugs. Effient prasugrel dose, indications, adverse effects.
Use of eptifibatide is considered contraindicated in patients who are dependent on renal dialysis. Center the spike within the circle on the stopper top. Eptifibatide is injected into a vein through an iv. The information contained in this book has been compiled. What are the possible side effects of eptifibatide integrilin. Ptt seconds dosing adjustment for heparin infusion check ptt less than 40 increase rate by 2 ml per hour 6 hours 41 to 49 increase rate by 1 ml per hour 6 hours 50 to 70 maintain rate, at goal next a. Integrilin eptifibatide uses, side effects, dosage. Integrilin eptifibatide dosing, indications, interactions. Drug dosing adjustments in patients with chronic kidney. Proceed to complete the diagnostic cardiac catheterization. Integrilin, inneptifibatide european medicines agency. In healthy subjects, renal clearance accounts for approximately 50% of total body clearance, with the majority of the drug excreted in the urine as eptifibatide, deaminated eptifibatide, and other, more polar metabolites. Assessment of eptifibatide dosing in renal impairment before.
Eptifibatide is eliminated via renal excretion, so dose adjustment is recommended with a creatinine clearance of less than 50 mlmin 2,64. In clinical trials, incidence of bleeding complications was higher in the elderly in both placebo and eptifibatide groups, and the incremental risk of eptifibatideassociated bleeding was greater in the older patients. Adult drugs analgesics antihypertensive and cardiovascular agents antimicrobial agents miscellaneous agents sedatives, hypnotics, and other drugs used in. Integrilin eptifibatide side effects, images, uses, dosage. Enabling research by provision of chemical tools poster the tocris chemistry team has considerable chemistry knowledge and skill which it has recently been applying to the generation of new chemical probes from known tools and compounds to help answer biological questions. Dailymed integrilin eptifibatide injection, solution. Assessment of eptifibatide clearance by hemodialysis using an in. Adult drugs analgesics antihypertensive and cardiovascular agents antimicrobial agents miscellaneous. Renal dosing modifications are intended to maximize outcomes through the establishment and maintenance of therapeutic drug concentrations, and minimize toxicity that may result from excessive accumulation of the drug or its metabolites.
Eptifibatide definition of eptifibatide by medical dictionary. Eptifibatide dosage needs to be adjusted in renal impairment. When administered alone, eptifibatide has no measurable effect on pt or aptt. Safety and efficacy of adjusteddose eptifibatide in patients. Aug 26, 2019 although there has been no clinical experience on the use of eptifibatide in patients on dialysis, in vitro studies suggest it is not extensively bound to plasma proteins and thus may be cleared from plasma by dialysis. Clearance in patients with coronary artery disease is about 55 mlkgh. Guidelines for the use of eptifibatide integrilin in acute coronary syndrome cardiovascular clinical program july2008 dosage and administration of eptifibatide diagnostic cardiac catheterization 1. A catalogue record for this book is available from the british library. Integrilin eptifibatide dose, indications, adverse effects. Withdraw the bolus doses of integrilin from the 10ml vial into a syringe. Drug dosing in renal insufficiency needs to be individualized whenever possible to optimize therapeutic outcomes and to minimize toxicity. Eptifibatide has been evaluated in acute coronary syndromes, extracorporeal bypass, and in normal human volunteers. Guidelines for the use of eptifibatide integrilin in acute.
Dec 29, 2019 the eptifibatide dosing regimen used in the esprit study included two 180mcgkg bolus doses given 10 minutes apart combined with a continuous 2mcgkgmin infusion. No major metabolites have been detected in human plasma. Esprit was a randomized, placebocontrolled trial that evaluated the use of eptifibatide in elective pci. Eptifibatide is a platelet aggregation inhibitor that prevents plateletsspecialized blood cellsfrom sticking together and clotting. Nov 09, 2018 eptifibatide is injected into a vein through an iv. Drug dosing in renal insufficiency talbert 1994 the. Renal drug handbook 3rd edition general intensive care unit. Nov 01, 2019 integrilin should be given concomitantly with heparin dosed to achieve the following parameters. Dosing guidelines book school of medicine university of. Renal dosage adjustment guidelines for antimicrobials.
Integrilin should be given concomitantly with heparin dosed to achieve the following. Withdraw bolus dose of eptifibatide from the 10 ml vial into a syringe. Novel dosing regimen of eptifibatide in planned coronary. Administer integrilinby volume according to patient weightsee table1. In patients with renal disease, renal function should be assessed prior to eptifibatide therapy. Detailed eptifibatide dosage information for adults. A model of dosing agreement among various methods of estimating creatinine clearance article pdf available in annals of pharmacotherapy 464. Although a number of published tables that provide dosing gu. Only if clinically necessary, restart iv heparin or sq enoxaparin 4 hours after sheath removal. Assessment of eptifibatide dosing in renal impairment before and after inservice education provided by pharmacists. If weight greater than or equal to 70 kg, 5000unit bolus followed by infusion of unitsh. The level of renal function below which the dose of a drug must be reduced depends largely on the extent of renal metabolism and elimination, and on the drugs toxicity. Although contraindicated in dialysis patients due to limited safety and.
Integrilin etifibatide injection etifibatide injection. Eptifibatide is a cyclic heptapeptide derived from a disintegrin protein found in the venom of the southeastern pygmy rattlesnake sistrurus miliarius barbouri. The present study was designed to assess teh pharmacokinetic and pharmacodynamic properties of eptifibatide in subjects with various levels of creatinine clearance crcl, a parameter that is a. When using an intravenous infusion pump, administer integrilin undiluted directly from the 100ml vial. Nov 01, 2019 clearance in patients with coronary artery disease is about 55 mlkgh. Eptifibatide should not be used in patients with renal failure and is contraindicated in patients with dependency on renal dialysis.
Munar, pharmd, bcps, and harleen singh, pharmd oregon state university college of pharmacy, portland, oregon. Continue heparin or enoxaparin, continue eptifibatide. See renal impairment under dosage and administration. What is the most important information i should know about eptifibatide integrilin.
Inspect integrilin for particulate matter and discoloration prior to administration, whenever solution and container permit. Includes dosages for myocardial infarction, angina pectoris, acute coronary syndrome and more. Pediatric drugs analgesics antihypertensive and cardiovascular agents antimicrobial agents. Eptifibatide supplier cas 188627807 tocris bioscience. May administer eptifibatide in the same intravenous line as alteplase, atropine, dobutamine, heparin, lidocaine, meperidine, metoprolol, midazolam, morphine, nitroglycerin, or verapamil. This book is distributed under the terms of the creative commons. Eptifibatide is eliminated via renal excretion, so dose adjustment is.
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