Indications
Tirofiban is an antiplatelet medicine given in hospital to people with acute coronary syndrome, such as unstable angina or a certain type of heart attack (non-ST elevation myocardial infarction). It is also used in some patients having coronary angioplasty and stenting, to prevent blood clots forming in the heart arteries.
How It Works
Platelets are blood cells that clump together to form clots. Tirofiban blocks a receptor on platelets called glycoprotein IIb/IIIa, which is the final step that lets platelets stick to each other. This quickly reduces clot formation in narrowed heart arteries. Its effect wears off within a few hours after the infusion is stopped.
Dosage and Administration
Tirofiban is given only in hospital by a doctor or nurse as an intravenous infusion, usually a starting dose followed by a continuous infusion. The dose is calculated by body weight and adjusted for kidney function, as prescribed. It is normally used together with Aspirin, Heparin and other antiplatelet medicines, with close monitoring.
Interactions
The risk of bleeding increases when it is combined with other medicines that affect clotting, such as Heparin, Enoxaparin, Warfarin, Clopidogrel, Ticagrelor, Aspirin, NSAIDs and clot-dissolving (thrombolytic) medicines. These combinations are used deliberately in hospital, with careful monitoring. It must not be combined with another glycoprotein IIb/IIIa inhibitor.
Contraindications
- Allergy to Tirofiban.
- Active bleeding, or major bleeding within the past 30 days.
- History of bleeding in the brain, brain tumour, aneurysm or arteriovenous malformation.
- Stroke within the past 30 days, or any haemorrhagic stroke.
- Major surgery or severe injury within the past month.
- Severely high blood pressure that is not controlled.
- Low platelet count, or low platelets after previous Tirofiban.
- Aortic dissection, pericarditis or severe liver failure.
Side Effects
The main side effect is bleeding, such as bleeding at the catheter or injection site, bruising, nosebleeds, bleeding gums or blood in the urine. Low platelet count (thrombocytopenia) can occur. Nausea, fever and headache may also occur.
Tell the nurse or doctor immediately if you notice heavy or ongoing bleeding, black stools, vomiting blood, sudden severe headache, weakness on one side, confusion or vision changes, or signs of an allergic reaction.
Pregnancy and Lactation
There is limited information on use in pregnancy and breastfeeding. It is used only if the doctor decides the benefit clearly outweighs the risk.
Precautions and Warnings
Platelet count, haemoglobin and clotting tests are checked before and during treatment. Care is taken with arterial puncture sites, and unnecessary injections or tubes are avoided. Extra caution is needed in older people, those with low body weight, kidney impairment, or a history of bleeding problems.
Overdose
Overdose mainly causes bleeding. The infusion is stopped, and treatment such as platelet or blood transfusion may be given by the hospital team. Tirofiban can be removed by haemodialysis.
Therapeutic Class
Antiplatelet agent, glycoprotein IIb/IIIa receptor antagonist.
Storage
Store as directed on the pack, usually below 30°C, away from light. Do not freeze. Keep out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.