Integrilin(EPTIFIBATIDE)

What is eptifibatide injection? What should I tell my health care provider before I take this medicine? How should this medicine be used? What if I miss a dose? What drug(s) may interact with eptifibatide? What side effects may I notice from receiving eptifibatide? What should I watch for while taking eptifibatide? Where can I keep my medicine?

EPTIFIBATIDE (Integrilin®) prevents your blood from clotting during episodes of chest pain or a heart attack, or while you are undergoing a procedure to treat a blocked coronary artery.

Eptifibatide is a cyclic heptapeptide containing six amino acids and one mercaptopropionyl (des-amino cysteinyl) residue. An interchain disulfide bridge is formed between the cysteine amide and the mercaptopropionyl moieties. Chemically it is N ⁶ -(aminoiminomethyl)-N ² -(3-mercapto-1-oxopropyl-L- lysylglycyl-L-a-aspartyl- L-tryptophyl-L -prolyl-L-cysteinamide, cyclic (1Ø6)-disulfide. Eptifibatide binds to the platelet receptor glycoprotein(GP) IIb/IIIa of human platelets and inhibits platelet aggregation.

INDICATIONS

INTEGRILIN is indicated:

• For the treatment of patients with acute coronary syndrome(UA/NQMI), including patients who are to be managed medically and those undergoing percutaneous coronary intervention(PCI). In this setting, INTEGRILIN has been shown to decrease the rate of a combined endpoint of death or new myocardial infarction.
• For the treatment of patients undergoing PCI. In this setting, INTEGRILIN has been shown to decrease the rate of a combined endpoint of death, new myocardial infarction or need for urgent intervention.

COMPLICATION

Bleeding. Bleeding is the most common complication encountered during eptifibatide therapy. Administration of eptifibatide is associated with an increase in major and minor bleeding, as classified by the criteria of the Thrombolysis in Myocardial Infarction.Most major bleeding associated with eptifibatide has been at the arterial acces site for cardiac catheterization or from the gasstrointestinal or genitourinary tract.

In patients undergoing percutaneous coronary interventions, patients receiving eptifibatide experience an increased incidense of major bleeding. Special care should be employed to minimize the risk of bleeding among these patients.If bleeding cannot be controlled with pressure, infusion of eptifibatide and concomitant heparin should be stopped immediately.

Renal Insufficiency. Approximately 50% of eptifibatide is cleared by the kidney in patients with normal renal function. Total drug clearance is decreased by approximately 50% and steady-state plasma eptifibatide concentrations are doubled in patients with an estimated creatinine clearance <50>2 mg/dL .

Platelet Count<100,000/mm³. Because it is an inhibitor of platelet agregation,caution should be exercised when administering eptifibatide to patients with a platelet count <100,000/mm³ ; there has been no clinical experience with eptifibatide initiated in patients with a platelet count <100,000/mm³.