Generic drug: eptifibatide
Brand name: Integrilin
What is Integrilin (eptifibatide), and how does it work?
Integrilin (eptifibatide) injection is a platelet aggregation inhibitor indicated for treatment of acute coronary syndrome (ACS) managed medically or with percutaneous coronary intervention (PCI), and treatment of patients undergoing PCI (including intracoronary stenting). Integrilin injection is available in generic form.
What are the side effects of Integrilin?
Common side effects of Integrilin injection include:
- low blood pressure
Tell your doctor if you have serious side effects of Integrilin injection including:
- easy bruising,
- unusual bleeding (nose, mouth, vagina, or rectum),
- purple or red pinpoint spots under your skin
- blood in your urine
- black, bloody, or tarry stools
- coughing up blood or vomit that looks like coffee grounds
- any bleeding that will not stop
- sudden numbness or weakness, especially on one side of the body
- sudden severe headache, confusion, problems with vision, speech, or balance
- fever, chills, body aches, flu symptoms, or
- feeling like you might pass out.
What is the dosage for Integrilin?
Before infusion of Integrilin, the following laboratory tests should be performed to identify pre-existing hemostatic abnormalities: hematocrit or hemoglobin, platelet count, serum creatinine, and PT/aPTT. In patients undergoing PCI, the activated clotting time (ACT) should also be measured.
The activated partial thromboplastin time (aPTT) should be maintained between 50 and 70 seconds unless PCI is to be performed. In patients treated with heparin, bleeding can be minimized by close monitoring of the aPTT and ACT.
Dosage In Acute Coronary Syndrome (ACS)
|Indication||Normal Renal Function||Creatinine Clearance less than 50 mL/min|
|Patients with ACS||180 mcg/kg intravenous (IV) bolus as soon as possible after diagnosis, followed by continuous infusion of 2 mcg/kg/min||180 mcg/kg IV bolus as soon as possible after diagnosis, followed by continuous infusion of 1 mcg/kg/min|
Integrilin should be given concomitantly with heparin dosed to achieve the following parameters:
During Medical Management
Target aPTT 50 to 70 seconds
- If weight greater than or equal to 70 kg, 5000-unit bolus followed by infusion of 1000 units/h.
- If weight less than 70 kg, 60-units/kg bolus followed by infusion of 12 units/kg/h.
Target ACT 200 to 300 seconds
- If heparin is initiated prior to PCI, additional boluses during PCI to maintain an ACT target of 200 to 300 seconds.
- Heparin infusion after the PCI is discouraged.
Dosage In Percutaneous Coronary Intervention (PCI)
|Indication||Normal Renal Function||Creatinine Clearance less than 50 mL/min|
|Patients with PCI||180 mcg/kg IV bolus immediately before PCI followed by continuous infusion of 2 mcg/kg/min and a second bolus of 180 mcg/kg (given 10 minutes after the first bolus)||180 mcg/kg IV bolus immediately before PCI followed by continuous infusion of 1 mcg/kg/min and a second bolus of 180 mcg/kg (given 10 minutes after the first bolus)|
- Integrilin should be given concomitantly with heparin to achieve a target ACT of 200 to 300 seconds. Administer 60-units/kg bolus initially in patients not treated with heparin within 6 hours prior to PCI.
- Additional boluses during PCI to maintain ACT within target.
- Heparin infusion after the PCI is strongly discouraged.
Patients requiring thrombolytic therapy should discontinue Integrilin.
Important Administration Instructions
- Inspect Integrilin for particulate matter and discoloration prior to administration, whenever solution and container permit.
- May administer Integrilin in the same intravenous line as alteplase, atropine, dobutamine, heparin, lidocaine, meperidine, metoprolol, midazolam, morphine, nitroglycerin, or verapamil. Do not administer Integrilin through the same intravenous line as furosemide.
- May administer Integrilin in the same IV line with 0.9% NaCl or 0.9% NaCl/5% dextrose. With either vehicle, the infusion may also contain up to 60 mEq/L of potassium chloride.
- Withdraw the bolus dose(s) of Integrilin from the 10-mL vial into a syringe. Administer the bolus dose(s) by IV push.
- Immediately following the bolus dose administration, initiate a continuous infusion of Integrilin. When using an intravenous infusion pump, administer Integrilin undiluted directly from the 100-mL vial. Spike the 100mL vial with a vented infusion set. Center the spike within the circle on the stopper top.
- Discard any unused portion left in the vial.
Administer Integrilin by volume according to patient weight (see Table 1).
Table 1: Integrilin Dosing Charts by Weight
|Patient Weight||180-mcg/kgBolus Volume||2-mcg/kg/minInfusion Volume
(CrCl greater than or equal to 50 mL/min)
(CrCl less than 50 mL/min)
|(kg)||(lb)||(from2-mg/mL vial)||(from 2-mg/mL100-mL vial)||(from 0.75-mg/mL100-mL vial)||(from 2-mg/mL100-mL vial)||(from 0.75-mg/mL100-mL vial)|
|37-41||81-91||3.4 mL||2 mL/h||6 mL/h||1 mL/h||3 mL/h|
|42-46||92-102||4 mL||2.5 mL/h||7 mL/h||1.3 mL/h||3.5 mL/h|
|47-53||103-117||4.5 mL||3 mL/h||8 mL/h||1.5 mL/h||4 mL/h|
|54-59||118-130||5 mL||3.5 mL/h||9 mL/h||1.8 mL/h||4.5 mL/h|
|60-65||131-143||5.6 mL||3.8 mL/h||10 mL/h||1.9 mL/h||5 mL/h|
|66-71||144-157||6.2 mL||4 mL/h||11 mL/h||2 mL/h||5.5 mL/h|
|72-78||158-172||6.8 mL||4.5 mL/h||12 mL/h||2.3 mL/h||6 mL/h|
|79-84||173-185||7.3 mL||5 mL/h||13 mL/h||2.5 mL/h||6.5 mL/h|
|85-90||186-198||7.9 mL||5.3 mL/h||14 mL/h||2.7 mL/h||7 mL/h|
|91-96||199-212||8.5 mL||5.6 mL/h||15 mL/h||2.8 mL/h||7.5 mL/h|
|97-103||213-227||9 mL||6 mL/h||16 mL/h||3.0 mL/h||8 mL/h|
|104-109||228-240||9.5 mL||6.4 mL/h||17 mL/h||3.2 mL/h||8.5 mL/h|
|110-115||241-253||10.2 mL||6.8 mL/h||18 mL/h||3.4 mL/h||9 mL/h|
|116-121||254-267||10.7 mL||7 mL/h||19 mL/h||3.5 mL/h||9.5 mL/h|
|>121||>267||11.3 mL||7.5 mL/h||20 mL/h||3.7 mL/h||10 mL/h|
What drugs interact with Integrilin?
Use Of Thrombolytics, Anticoagulants, And Other Antiplatelet Agents
Is Integrilin safe to use while pregnant or breastfeeding?
- Available data on eptifibatide use in pregnant women from published literature and the pharmacovigilance database are insufficient to establish a drug-associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes.
- Untreated myocardial infarction can be fatal to the pregnant woman and fetus.
- There are no available data on the presence of eptifibatide in human milk, the effects on the breastfed infant, or the effects on milk production.
- As eptifibatide is a peptide, it is likely to be destroyed in the infant's gastrointestinal tract and not absorbed orally by the breastfed infant.
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Integrilin (eptifibatide) injection is a platelet aggregation inhibitor indicated for treatment of acute coronary syndrome (ACS) managed medically or with percutaneous coronary intervention (PCI), and treatment of patients undergoing PCI (including intracoronary stenting). Integrilin injection is available in generic form. Common side effects of Integrilin injection include bleeding and low blood pressure.
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