This is an automatically translated article.
Eptifibatide contains the main ingredient Eptifibatide with a concentration of 0.75mg/1ml - a platelet aggregation inhibitor, belonging to the RGD-like subgroup (Arginine Glycine - Aspartate). It is used to treat patients with acute coronary syndromes or undergoing percutaneous coronary intervention (PCI).
1. What is Eptifibatide?
Eptifibatide is only used when prescribed by a cardiologist. The drug is a product of Gland Pharma Ltd (India) and is prepared in the form of a sterile solution for infusion (box of 1 bottle of 10ml).
Each ml of Eptifibatide contains 0.75mg of Eptifibatide and some other excipients just enough including: Citric acid monohydrate, sodium hydroxide and distilled water for injection.
2. What are the uses of Eptifibatide?
The drug is used with 2 main purposes as follows:
Treatment of patients with acute coronary syndromes (unstable angina or non-ST elevation myocardial infarction); The patient underwent percutaneous coronary intervention (PCI). Eptifibatide is a synthetic cyclic heptapeptide containing 6 amino acids, consisting of a cysteine amide and a mercaptopropionyl moiety (desamino cysteinyl), a platelet aggregation inhibitor of the RDG class. Eptifibatide has a mechanism of action through the reversible inhibition of platelet aggregation by blocking the formation of fibrinogen, von Willebrand factor and other glycoprotein (GP) IIb/IIIa receptor ligands.
The half-life of the drug in plasma is about 2.5 hours.
3. Instructions for using Eptifibatide
Eptifibatide is only used when there is a medical order of an experienced specialist and performed in the hospital, absolutely do not use it arbitrarily. Eptifibatide is recommended for use in adult patients (≥ 18 years of age) and concomitant use with Acetylsalicylic Acid, Unfractionated Heparin (UFH).
Eptifibatide may be reconstituted with 0.9% NaCl or 0.9% NaCl/Dextrose 5% solution.
Dosage is as follows:
Unstable angina/non-Q wave myocardial infarction: Once diagnosed, a rapid intravenous dose of 180 μg/kg, as a continuous infusion of 2 μg/kg for up to 72 hours, gives until coronary artery bypass graft (CABG) surgery or hospital discharge. If PCI is performed during drug therapy, continue infusion 20-24 hours after the procedure, for a maximum total infusion time of 96 hours. Performing PCI: Rapid intravenous injection of 180μg/kg, given immediately before the procedure, followed by a continuous infusion of 2μg/kg/min and a second dose of 180μg/kg 10 minutes after the first dose first. Maintain until discharge or infusion time up to 18-24 hours. The infusion should be given over a minimum of 12 hours. Children and adolescents under 18 years of age: Not recommended due to lack of data on safety and efficacy. Pregnant or lactating women: Do not use unless absolutely necessary. Patients requiring emergency or urgent surgery during treatment with Eptifibatide: Stop the infusion immediately. Patients requiring subacute surgery: Discontinue infusion and wait for an appropriate period of time for platelet function to return to normal. Do not use Eptifibatide if the patient has one of the following contraindications:
Hypersensitivity to Eptifibatide or any of its ingredients. Gastrointestinal bleeding, hematuria, or other unusual bleeding within 30 days prior to treatment. Stroke within 30 days or any history of hemorrhagic stroke. History of intracranial disease. Surgery or major trauma within 6 weeks. History of visceral bleeding. Thrombocytopenia < 100,000/mm3. Severe uncontrolled hypertension. Prothrombin time > 1.2 times, or International Normalized Ratio (INR) ≥ 2.0. Severe renal failure (creatinine clearance < 30ml/min) or hemodialysis. Severe liver failure. Concomitant or planned use with other GP IIb/IIIa antagonists. Caution should be exercised in patients with renal impairment because renally excreted drugs account for 50% of body clearance. Therefore, for moderate and severe renal impairment (creatinine clearance < 50 ml/min), Eptifibatide clearance is reduced by approximately 50%, plasma concentrations are doubled. In this subject, after a rapid injection of the first dose, a continuous infusion of 1 μg/kg/min was immediately administered.
In addition, for patients undergoing CABG, the Eptifibatide infusion should be discontinued prior to surgery.
At present, treatment experience in patients with hepatic impairment is very limited, therefore caution should be exercised in patients with hepatic impairment with coagulopathy.
If it is necessary to use the drug in a bleeding patient, close monitoring is recommended. Especially places with risk of bleeding such as: Place of insertion of urinary catheters, arteries, veins or needle sites, gastrointestinal tract - intestinal tract, genitourinary tract - urinary tract, central nervous system and the central nervous system. Peripheral, peritoneal peritoneum needs to be carefully observed.
Besides, before infusion of Eptifibatide, it is recommended to check the following paraclinical tests to detect coagulation abnormalities in time:
Prothrombin time (PT). aPTT. Serum creatinine. Platelet count. Haemoglobin or Haematocrit. An overdose of Eptifibatide can cause bleeding. At that time, the infusion should be stopped.
4. Drug interactions
Eptifibatide does not increase the risk of major and minor bleeding when used concomitantly with Warfarin and Dipyridamole. Data are still limited on an increased risk of bleeding when used with other hemolytic agents. Concomitant treatment with Eptifibatide with other GP IIb/IIIa platelet inhibitors should be avoided. Eptifibatide is not compatible with Furosemide.
5. Eptifibatide side effects
Possible side effects of Eptifibatide include:
Myocardial bleeding. Hematuria. Hemoptisi . Bleed. Intracranial hemorrhage. Cardiac arrest. Ventricular fibrillation Other cardiac toxicity, especially in patients with previous history: Atrial fibrillation, ventricular tachycardia, atrioventricular conduction block,... Rarely bleeding leading to death. The article has provided information on what Eptifibatide is used for, dosage and precautions for use. To ensure safety for your health and maximize the effectiveness of your treatment, you need to take Eptifibatide exactly as directed by your doctor.
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