Tirofiban


Concise Prescribing Info
Indications/Uses
Acute coronary syndrome.
Dosage/Direction for Use
Adult : IV Combined w/ unfractioned heparin and oral antiplatelet therapy: Patients w/ STEMI undergoing primary PCI or patients w/ NSTEMI undergoing PCI w/in 4 hr of diagnosis: Initial: 25 mcg/kg bolus then 0.15 mcg/kg/min, infused for 12-24 hr, up to max 48 hr. Patients w/ NSTEMI undergoing PCI >4 hr after diagnosis: Initial: 0.4 mcg/kg/min then 0.1 mcg/kg/min for at least 48 hr; may continue during coronary angiography and 12-24 hr after angioplasty or atherectomy. Max duration: 108 hr.
Dosage Details
Intravenous
Acute coronary syndrome
Adult: In combination w/ unfractioned heparin and oral antiplatelet therapy, including aspirin: Patients w/ ST-elevation MI (STEMI) undergoing primary PCI or patients w/ non-ST-elevation MI (NSTEMI) undergoing PCI w/in 4 hr of diagnosis: Initially, 25 mcg/kg bolus over 3 min followed by a continuous infusion of 0.15 mcg/kg/min for 12-24 hr. Max duration: 48 hr. Patients w/ NSTEMI undergoing PCI >4 hr after diagnosis: Initially, 0.4 mcg/kg/min for 30 min followed by 0.1 mcg/kg/min, started at the time of diagnosis and continued for at least 48 hr. Infusion may be continued during coronary angiography and maintained for 12-24 hr after angioplasty or atherectomy. Max duration: 108 hr.
Renal Impairment
CrCl (mL/min) Dosage
<30 Reduce dose by 50%.
Hepatic Impairment
Severe: Contraindicated.
Reconstitution
Aspirate and discard 50 or 100 mL of soln from a 250 or 500 mL bag, respectively, of NaCl 0.9% or dextrose 5% inj and replace this volume w/ 50 mL (12.5 mg) or 100 mL (25 mg) of tirofiban inj to achieve a final concentration of 50 mcg/mL.
Incompatibility
Y-site admin: Incompatible w/ diazepam.
Contraindications
History of thrombocytopenia during earlier use of GP IIb/IIIa receptor antagonist; history of stroke w/in 30 days or history of haemorrhagic stroke; history of intracranial disease (e.g. neoplasm, aneurysm); active or recent (w/in 30 days) clinically relevant bleeding (e.g. GI bleeding); malignant HTN; relevant trauma or major surgery (w/in the past 6 wk); thrombocytopenia (platelet count <100,000/mm3), disorders of platelet function; clotting disturbances. Severe hepatic failure.
Special Precautions
Patient w/ anaemia, active peptic ulcer (w/in the past 3 mth), uncontrolled HTN, acute pericarditis, active or history of vasculitis, suspected aortic dissection, haemorrhagic retinopathy, occult blood in stool or haematuria, thrombocytopenia (platelet count <150,000/mm3) or known history of platelet function disturbance, recent bleeding (<1 yr), severe CHF, cardiogenic shock. Severe trauma or surgery (>6 wk but <3 mth previously); traumatic or protracted CPR, organ biopsy or lithotripsy (w/in the past 2 wk), puncture of a non-compressible vessel (w/in 24 hr), recent epidural procedure. Renal and mild to moderate hepatic impairment. Pregnancy and lactation.
Adverse Reactions
Nausea, headache, fever, rashes and other hypersensitivity reactions, thrombocytopenia, anaemia, minor bleeding (e.g. mild mucocutaneous bleeding).
Potentially Fatal: Major bleeding (e.g. intracranial or retroperitoneal haemorrhage).
IV/Parenteral: B
MonitoringParameters
Monitor signs of bleeding, platelet counts, activated thromboplastin time (aPTT), haematocrit and Hb before and periodically (e.g. w/in the first 6 hr of the loading infusion and daily thereafter).
Overdosage
Symptoms: Bleeding, usually at mucocutaneous and cardiac catheterisation sites. Intracranial haemorrhage and retroperitoneal bleeding may also occur. Management: Transfusion of blood and/or thrombocytes may be considered if treatment for haemorrhage is necessary.
Drug Interactions
Increased risk of bleeding w/ drugs that affect haemostasis including anticoagulants, thrombolytics, other glycoprotein IIb/IIIa inhibitors, platelet aggregation inhibitors.
Action
Description: Tirofiban is a non-peptide tyrosine derivative that prevents fibrinogen binding to the glycoprotein (GP) IIb/IIIa receptor, leading to inhibition of platelet function, evidenced by its ability to inhibit ex vivo ADP-induced platelet aggregation and prolong bleeding time.
Onset: Inhibition of platelet aggregation: W/in 10 min.
Pharmacokinetics:
Distribution: Volume of distribution: 22-42 L. Plasma protein binding: 65%.
Excretion: Via urine (65%) and faeces (25%) primarily as unchanged drug. Elimination half-life: Approx 2 hr.
Chemical Structure

Click on icon to see table/diagram/image
Storage
Store between 15-30°C. Protect from light. Do not freeze.
ATC Classification
B01AC17 - tirofiban ; Belongs to the class of platelet aggregation inhibitors excluding heparin. Used in the treatment of thrombosis.
Disclaimer: This information is independently developed by MIMS based on Tirofiban from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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