Integril

Indications

Eptifibatide is used in hospital for people with acute coronary syndrome, which includes unstable angina (sudden chest pain at rest) and certain types of heart attack. It is also used during percutaneous coronary intervention (PCI), a procedure to open narrowed heart arteries with a balloon or stent, to lower the risk of a new heart attack or a clot forming.

How It Works

Blood cells called platelets stick together to form clots. They do this using receptors on their surface called glycoprotein IIb/IIIa. Eptifibatide blocks these receptors, so platelets cannot clump together. This helps stop clots from forming in the heart arteries. Its effect wears off within a few hours after the infusion stops.

Dosage and Administration

Eptifibatide is given by a doctor or nurse into a vein, usually as a quick injection (bolus) followed by a continuous drip. The dose is calculated from body weight and kidney function and is set by the cardiologist. It is usually given together with Aspirin and Heparin.

Interactions

The risk of bleeding is higher when used with other blood thinners and clot medicines, such as Heparin, Warfarin, Clopidogrel, Ticagrelor, Aspirin, clot-dissolving drugs (thrombolytics) and painkillers like Ibuprofen. It must not be given with another glycoprotein IIb/IIIa blocker such as Tirofiban or Abciximab.

Contraindications

Not used in people with active bleeding, recent serious bleeding (within the past month), a history of stroke within 30 days or any bleeding stroke, very high uncontrolled blood pressure, recent major surgery or injury, a very low platelet count, severe kidney failure needing dialysis, or allergy to eptifibatide.

Side Effects

Bleeding is the main side effect, such as bleeding at the catheter site, from the gums, nose, stomach or urine. Low blood pressure and a fall in platelet count can also occur.

Tell the nurse or doctor at once about any bleeding that does not stop, blood in urine or stool, black stools, vomiting blood, sudden severe headache, weakness on one side of the body, confusion, or signs of an allergic reaction.

Pregnancy and Lactation

There is little information in pregnancy; it is used only if the doctor judges it clearly needed. It is not known if it passes into breast milk; the doctor will advise on breastfeeding during treatment.

Precautions and Warnings

Blood counts, clotting tests and kidney function are checked before and during treatment. Care is taken with injection and catheter sites to reduce bleeding. Older people, those with low body weight and those with kidney problems need extra care with dosing.

Overdose

Overdose mainly causes bleeding. The infusion is stopped, and because its effect is short, platelet function usually returns within hours. Bleeding is treated as needed, sometimes with transfusion.

Therapeutic Class

Antiplatelet agent (glycoprotein IIb/IIIa inhibitor).

Storage

Store as directed on the pack, usually in a refrigerator at 2 to 8°C, do not freeze, protected from light. Hospital use only; keep out of the reach of children.