Drug reference

Abciximab

Antiplatelet

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

Use antiplatelet doses with caution during

FDA category + note

Top interactionssee all 12 →

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Mechanism

Abciximab is a monoclonal antibody that prevents platelet aggregation by blocking the binding of fibrinogen to glycoprotein IIb/IIIa receptors on platelets. It also binds to other related sites.

Indications

As an adjunct to unfractionated heparin and aspirin for the prevention of ischaemic complications in high-risk patients undergoing percutaneous transluminal coronary intervention (PTCI).Reduction of the immediate risk of vascular occlusion in intermediate- and high-risk patients undergoing percutaneous coronary intervention (in combination with unfractionated heparin and aspirin).Reduction of morbidity in patients with angina who undergo coronary artery stenting.patients undergoing percutaneous coronary intervention (in conjunction with aspirin and heparin) to prevent recurrent myocardial infarction and deathcoronary intervention for acute coronary syndromeReduce restenosis, subsequent MI, and death during PCI (with aspirin + heparin)Unstable anginaAdjuvant to coronary thrombolysis/PCI with stent placement

Dosing

Adult: ▶ BY MOUTH ▶ ▶ BY RECTUM Adult: 450–900 mg every 4 hours; maximum 3.6 g per day Acute migraine ▶ ▶ BY MOUTH Adult: 900 mg for 1 dose, to be taken as soon as migraine symptoms develop Prevention of pre-eclampsia in women at moderate or high risk ▶ ▶ BY MOUTH Adult: 75–150 mg once daily from 12 weeks gestation until the birth of the baby Mild to moderate pain (dose approved for use by community prac…

Pharmacokinetics

Duration

antibody remains bound to the αIIbβ3 receptor and inhibits platelet aggregation for 18 to 24 h after infusion

Half-life

about 30 min (circulating antibody)

Contraindications

Should be used once only due to the additional risk of thrombocytopenia with repeated use.
similar to fibrinolytic agents (prior intracranial hemorrhage, known structural cerebral vascular lesion, known malignant intracranial neoplasm, ischemic stroke within 3 months, suspected aortic dissection, active bleeding or bleeding diathesis, significant closed-head trauma or facial trauma within 3 months, uncontrolled hypertension, traumatic or prolonged CPR or major surgery within 3 weeks, recent internal bleeding, noncompressible vascular punctures, pregnancy, active peptic ulcer, current use of warfarin and INR >1.7)

Side effects

Common

bleeding (1% to 10% frequency of major hemorrhage)ConstipationIleusArrhythmias

Serious

Thrombocytopenia
thrombocytopenia (with a platelet count below 50,000/μL in about 2% of patients, potentially due to antibodies against neoepitopes)
pseudothrombocytopenia (laboratory artifact)
human anti-chimeric antibodies (upon re-administration)
hypersensitivity reactions (enhanced risk upon re-administration)
Haemorrhage
Thrombocytopenia (increased risk with second use)
Bleeding
Thrombocytopenia (up to 5% of patients, severe in ~1%)