Integril

Eptifibatide is indicated in-

• Patients with acute coronary syndrome (unstable angina/non-ST- segment elevation myocardial infarction), including patients who are to be managed medically and those undergoing percutaneous coronary intervention (PCI).
• Patients undergoing PCI, including those undergoing intracoronary stenting.

Eptifibatide is a cyclic heptapeptide containing six amino acids and one mercaptopropionyl (des-amino cysteinyl) residue. Integril binds to the platelet receptor glycoprotein (GP) IIb/IIIa of human platelets and reversibly inhibits platelet aggregation by preventing the binding of fibrinogen, von Willebrand factor, and other adhesive ligands to GP IIb/IIIa.

• In various clinical studies, eptifibatide was used concomitantly with unfractionated heparin and aspirin. In another study, clopidogrel or ticlopidine were used routinely starting the day of PCI. Because eptifibatide inhibits platelet aggregation, caution should be employed when it is used with other drugs that affect hemostasis, including thrombolytics, oral anticoagulants, NSAIDS and dipyridamole. To avoid potentially additive pharmacologic effects, concomitant treatment with other inhibitors of platelet receptor GP IIb/IIIa should be avoided

• Enoxaparin did not alter the pharmacokinetics of Integril

Bleeding is the most common adverse effect. Adverse reactions include intracranial hemorrhage & stroke, thrombocytopenia, allergic reactions and hypotension.

Pregnancy: Category B. Animal studies revealed no evidence of harm to the fetus due to Integril. There are, however, no adequate and well-controlled studies in pregnant women with Integril.

Lactating Mothers: It is not known whether Integril is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Integril is administered to a nursing mother.

Use in Children: Safety and effectiveness of Integril in pediatric patients have not been studied.

Anti-platelet drugs

• There has been only limited experience with overdosage of Integril. Symptoms of acute toxicity were loss of righting reflex, dyspnea, ptosis, and decreased muscle tone in rabbits, and petechial hemorrhages in the femoral and abdominal areas of monkeys.

• From in vitro studies, eptifibatide is not extensively bound to plasma proteins and thus may be cleared from plasma by dialysis.

• Vials should be stored refrigerated at 2-8° C
• Vials may be transferred to room temperature storage for up to 2 months.
• Unused portion left in the vial should be discarded.
• Vials should be protected from light until administration.