Drug reference

Tirofiban

Antiplatelet · Acute Coronary Syndrome treatment

Also known as Aggrastat

AntiplateletAcute Coronary Syndrome treatment

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

Manufacturer advises use only if potential benefit outweighs risk—no information available.

FDA category + note

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Mechanism

Tirofiban is an anti-integrin drug that exerts antiplatelet effects by inhibiting platelet aggregation, thereby reducing intracoronary thrombosis and preventing early myocardial infarction.

Indications

In combination with unfractionated heparin, aspirin, and clopidogrel for prevention of early myocardial infarction in patients with unstable angina or non-ST-segment-elevation myocardial infarction (NSTEMI) and with last episode of chest pain within 12 hours (with angiography planned for 4–48 hours after diagnosis) (initiated under specialist supervision)In combination with unfractionated heparin, aspirin, and clopidogrel for prevention of early myocardial infarction in patients with unstable angina or non-ST-segment-elevation myocardial infarction (NSTEMI) and with last episode of chest pain within 12 hours (with angiography within 4 hours of diagnosis) (initiated under specialist supervision)In combination with unfractionated heparin, aspirin, and clopidogrel for reduction of major cardiovascular events in patients with ST-segment elevation myocardial infarctionmanagement of patients with non–ST-segment elevation acute coronary syndromeAcute coronary syndromesCoronary angioplastyPatients undergoing PCI with a high coronary thrombus burden or thrombotic complications of PCI

Dosing

Adult: For prevention of early myocardial infarction in unstable angina or NSTEMI with angiography planned for 4–48 hours after diagnosis: Initially 400 nanograms/kg/minute by intravenous infusion for 30 minutes, then 100 nanograms/kg/minute for at least 48 hours (continue during and for 12–24 hours after percutaneous coronary intervention), maximum duration of treatment 108 hours.…
Renal adjustment: Use half normal dose if eGFR less than 30 mL/minute/1.73 m2.
Hepatic adjustment: Manufacturer advises caution in mild to moderate hepatic failure; avoid in severe hepatic failure (no information available).

Pharmacokinetics

Duration

short duration of action

Half-life

2 hours (plasma)

Contraindications

active pathological bleeding
history of intracranial haemorrhage
intracranial neoplasm
arteriovenous malformation
aneurysm
history of thrombocytopenia with prior use of glycoprotein IIb/IIIa inhibitor
history of stroke within 30 days
history of haemorrhagic stroke at any time
major surgical procedure within last 6 weeks
organ biopsy within last 2 weeks
significant traumatic or protracted cardiopulmonary resuscitation within last 2 weeks
uncontrolled severe hypertension
vasculitis