| Indications:
Treatment of patients with acute coronary syndrome
(unstable angina or Non-Q wave MI). Administration:
Bolus: withdraw dose from 10ml vial and give by ivpush
over 1-2 minutes. Continuous infusion: administer
calculated rate directly from 100ml vial. [Supplied:
0.75 mg/ml (100ml) vial; 20 mg/10 ml vial. (REF) ] Properties:
Onset: within 1 hr. // T1/2: 2.5
hours // Platelet function restored in
@ 4hours after discontinuation.
Acute Coronary
Syndrome: The recommended adult dosage of
eptifibatide in patients with acute coronary syndrome
and normal renal function is an intravenous bolus of 180
µg/kg (maximum: 22.6 mg) over 1-2 minutes as
soon as possible following diagnosis, followed by a
continuous infusion of 2.0 µg/kg/min (maximum:
15 mg/hour) until hospital discharge or initiation of
CABG surgery, up to 72 hours. If a patient is to undergo
a percutaneous coronary intervention (PCI) while
receiving eptifibatide, the infusion should be continued
up to hospital discharge, or for up to 18-24 hours after
the procedure, whichever comes first, allowing for up to
96 hours of therapy. Concurrent aspirin (160-325 mg
initially and daily thereafter) and heparin therapy
(target aPTT 50-70 seconds) are recommended.
| Dosing
adjustment in renal impairment:
Patients with CRCL less than 50 ml/min:
The recommended adult dosage of eptifibatide
in patients with acute coronary syndrome with
an estimated CRCL <50 ml/min (using the
Cockcroft-Gault equation) is an IV bolus
of 180 µg/kg (maximum: 22.6 mg) as soon as
possible following diagnosis, immediately
followed by a continuous infusion of 1.0 µg/kg/min
(maximum: 7.5 mg/hour). |
Percutaneous
Coronary Intervention (PCI): The recommended
adult dosage of eptifibatide in patients with normal
renal function is an intravenous bolus of 180 µg/kg (maximum:
22.6 mg) over 1-2 minutes administered immediately
before the initiation of PCI followed by a continuous
infusion of 2.0 µg/kg/min (maximum: 15 mg/hour)
and a second 180 µg/kg bolus (maximum: 22.6 mg)
10 minutes after the first bolus. Infusion should be
continued until hospital discharge, or for up to 18 to
24 hours, whichever comes first. A minimum of 12 hours
of infusion is recommended. Concurrent aspirin (160-325
mg 1-24 hours before PCI and daily thereafter) and
heparin therapy (ACT 200-300 seconds during PCI) are
recommended. Heparin infusion after PCI is discouraged.
| Dosing
adjustment in renal impairment:
Patients with CRCL less than 50 mL/min:
The recommended adult dose of eptifibatide in
patients with an estimated CRCL < 50 ml/min
(using the Cockcroft-Gault equation) is an IV
bolus of 180 µg/kg (maximum: 22.6 mg)
administered immediately before the initiation
of the procedure, immediately followed by a
continuous infusion of 1.0 µg/kg/min
(maximum: 7.5 mg/hour) and a second 180 µg/kg
bolus (maximum: 22.6 mg) administered 10
minutes after the first. In patients who
undergo coronary artery bypass graft surgery,
eptifibatide infusion should be discontinued
prior to surgery. |
Use
the Cockcroft-Gault equation with actual body
weight to calculate CRCL:
Males:
[ (140 – age) x (actual body wt in kg) ]
----------------------------------------
72 x (serum creatinine)
Females:
[ (140 – age) x (actual body wt in kg)
x (0.85)]
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72 x (serum creatinine)
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