Eptifibatide (Intravenous)

Eptifibatide is a drug that is used to stop blood clots forming in patients who have suffered heart attacks or undergone certain types of heart surgery.

Overview

Eptifibatide is sold in the US under the brand name, Integrilin. The drug may only be administered by a trained medical professional, usually in a clinic or hospital setting. The medicine is prescribed in solution form and is given intravenously.

This drug is given to patients who are recovering from heart or blood vessel procedures, including coronary angioplasty. It is also given as a preventative measure to ward off heart attacks. The medicine is an anticlotting agent that stops the formation of blood clots in the heart's arteries. Blood clots can cause blockages in the patient's blood vessels, potentially leading to an increased risk of embolism.

Conditions treated

  • Heart and blood vessel disease
  • Post-surgery to prevent blood clots

Type of medicine

  • Anticoagulant
  • Intravenous solution

Side effects

Some medicines cause unwanted side effects, as well as providing the benefits that they are intended to. Not every patient will notice an adverse effect while being treated with eptifibatide. However, if you do experience any of the following effects, you may need to seek medical attention:

  • Wheezing
  • Weakness
  • Vomiting of blood or material resembling coffee grounds
  • Unusual tiredness or weakness
  • Tightness of the chest
  • Sweating
  • Slow speech
  • Skin rash
  • Shortness of breath
  • Severe stomach pain
  • Dark brown or reddish urine
  • Black or red, tarry stools
  • Swelling or puffiness around the eyes, of the eyelids, face, tongue, or lips
  • Bleeding from cuts that is slow to stop
  • Tiny red skin spots
  • Paralysis
  • Nosebleeds
  • Nausea and vomiting
  • Itching
  • Increased vaginal or menstrual bleeding
  • Inability to speak
  • Paralysis of the arms, facial muscles, or legs
  • Hives
  • Sudden, severe headache
  • Fast heartbeat
  • Double vision
  • Feeling dizzy, faint, or lightheaded when getting up from a seated or lying position
  • Difficulty swallowing
  • Difficulty speaking
  • Problems breathing or swallowing
  • Coughing up blood
  • Cough
  • Constipation
  • Confusion
  • Blurred vision
  • Blood in the urine
  • Bleeding gums
  • Back pain or backaches
  • Abdominal or stomach pain or bloating

This list of possible side effects is not necessarily all-inclusive. If you have any other effects that are not mentioned here, have a chat with your GP.

Some patients suffer from localized itching and irritation around the site of their injection. These effects generally disappear within a few days or receiving the treatment. However, if your skin becomes very inflamed, painful, red, or itchy, tell your nurse or doctor straight away. If the site has become infected, you may need further treatment.

Dosage

You will only be given eptifibatide by a trained medical professional, usually, while you are receiving treatment in a hospital or in a clinic setting.

The medication is administered intravenously. This means that a nurse will place a fine tube called a cannula into one of your veins. The drug solution will slowly be injected into your vein via the cannula. The medication is usually infused slowly over a period of a few days, while you are recovering from your surgery or another event. During the course of your treatment with this drug, you will be closely monitored to ensure that the medicine is working properly and that you are not suffering from any unwanted side effects.

It is usual for patients receiving eptifibatide to also be given other anticlotting medications, such as heparin or aspirin. These other drugs are also blood thinning agents, and you should be aware that the risk of you suffering bleeding that is very difficult to stop may be increased.

Interactions

It is the case that some medications should never be used in conjunction with each other, as doing so can cause potentially harmful interactions. In other cases, it may be appropriate to your treatment for you to take two or more medicines at the same time, even though doing so may cause an interaction to take place. Your GP may elect to reduce or remove one or more of the drugs or he may change the dose or frequency of use.

You must, therefore, tell your doctor if you are taking any other forms of medication, especially those that are mentioned below.

Taking eptifibatide with any of the medications listed below is not recommended, although it may be necessary in some cases. Your doctor may change your dose or discontinue your use of one or more of these drugs, until you have completed your treatment with eptifibatide.

  • Warfarin
  • Vortioxetine
  • Vitamin A
  • Vilazodone
  • Venlafaxine
  • Valdecoxib
  • Treprostinil
  • Tolmetin
  • Tolfenamic Acid
  • Tirofiban
  • Tinzaparin
  • Ticlopidine
  • Ticagrelor
  • Tiaprofenic Acid
  • Tenoxicam
  • Sulindac
  • Sulfinpyrazone
  • Sodium Salicylate
  • Sertraline
  • Salsalate
  • Salicylic Acid
  • Rofecoxib
  • Rivaroxaban
  • Reviparin
  • Protein C
  • Proquazone
  • Propyphenazone
  • Proglumetacin
  • Prasugrel
  • Piroxicam
  • Piracetam
  • Piketoprofen
  • Phenylbutazone
  • Phenprocoumon
  • Phenindione
  • Paroxetine
  • Parnaparin
  • Parecoxib
  • Oxyphenbutazone
  • Oxaprozin
  • Nimesulide Beta Cyclodextrin
  • Nimesulide
  • Niflumic Acid
  • Nepafenac
  • Nefazodone
  • Naproxen
  • Nadroparin
  • Nabumetone
  • Morniflumate
  • Milnacipran
  • Meloxicam
  • Mefenamic Acid
  • Meclofenamate
  • Lumiracoxib
  • Loxoprofen
  • Lornoxicam
  • Levomilnacipran
  • Lepirudin
  • Ketorolac
  • Ketoprofen
  • Indomethacin
  • Ibuprofen
  • Heparin
  • Fondaparinux
  • Fluvoxamine
  • Flurbiprofen
  • Fluoxetine
  • Flufenamic Acid
  • Floctafenine
  • Feprazone
  • Fepradinol
  • Fenoprofen
  • Felbinac
  • Etoricoxib
  • Etofenamate
  • Etodolac
  • Escitalopram
  • Enoxaparin
  • Edoxaban
  • Duloxetine
  • Droxicam
  • Dipyrone
  • Dipyridamole
  • Diflunisal
  • Diclofenac
  • Dexketoprofen
  • Dexibuprofen
  • Desvenlafaxine
  • Desirudin
  • Defibrotide
  • Danaparoid
  • Dalteparin
  • Dabigatran Etexilate
  • Clopidogrel
  • Clonixin
  • Citalopram
  • Cilostazol
  • Choline Salicylate
  • Certoparin
  • Celecoxib
  • Bufexamac
  • Bromfenac
  • Bivalirudin
  • Bemiparin
  • Aspirin
  • Argatroban
  • Ardeparin
  • Apixaban
  • Anagrelide
  • Amtolmetin Guacil
  • Alteplase, Recombinant
  • Alipogene Tiparvovec
  • Acemetacin
  • Aceclofenac
  • Abciximab

Some medicines should not be taken when you are eating or with certain food groups, as doing so may cause an interaction. Similarly, using tobacco or consuming alcohol with some drugs can cause interactions. You should discuss your use of particular foods, alcohol, and tobacco during your treatment with eptifibatide with your treating physician.

Warnings

Before deciding to undergo treatment with any drug, you should discuss with your doctor the benefits it will have against the risks it may present. Based on this discussion, you can decide whether to take the medication or not. There are a number of risks that may be presented by using eptifibatide, and you should take note of the following information before commencing treatment.

Be sure to tell your treating physician if you have ever suffered from any strange or unexpected reactions when taking eptifibatide or any other prescribed or over the counter medicine. You should also mention any allergies that you have to food colors, food preservatives, animal derivatives, or particular food groups.

Geriatric patients

Although there have not been any studies carried out into the specific effects of eptifibatide on elderly patients, people in this age group may be more likely to have problems with bleeding. It is therefore necessary to exercise extra caution when using this drug in geriatric patients.

Pregnancy and breastfeeding

Although there is no research that suggests using eptifibatide during pregnancy can harm the fetus, it is important that you discuss the potential risks against the benefits of doing so with your health professional. This is especially important during the last trimester of pregnancy when there is a greater risk of bleeding due to premature labor.

Similarly, women who are breastfeeding may wish to discuss with their doctor or midwife the implications of doing so while taking this drug. To be on the safe side, it may be best to adopt an alternative method of feeding your infant until such time as your treatment with this medication has finished.

Medical check-ups

Throughout the course of your treatment with this medication and after you have been discharged from hospital, you will need to have regular medical checks to make sure that the drug is working properly and to discuss any side effects that you may have noticed. Make sure that you attend all these appointments.

Complications

Some people find that they bruise and bleed more easily while they are being treated with this medication. Even after you have been released from hospital and are no longer receiving the drug, you may experience these side effects for a few days. As a precaution, blow your nose very gently if you need to do so and avoid picking it. If these effects persist for more than three days, mention it to your doctor.

Because of the increased likelihood of bleeding, you must be vigilant for signs of unusual bruising or bleeding. If you notice pinpoint dots on your skin, blood in your stools or urine, or tarry, black stools, tell your GP straight away.

In order to reduce the risk of bleeding, you should switch to a very soft toothbrush and shave using an electric razor, rather than a razor blade until a few days after your treatment with this drug has finished.

While you are receiving eptifibatide, be vigilant for any bleeding from areas such as needle punctures, or where a cannula or catheter has been inserted for an angioplasty or heart catheterization. You must also check your urine and stools to ensure that there is no blood present. Any injuries or bleeding should be reported to your GP immediately.

Medical history

There are a number of historical or pre-existing medical conditions that can affect the way in which eptifibatide works. Be sure to discuss your medical history fully with your treating physician before you start treatment with the medication.

Because of the danger of persistent bleeding, eptifibatide should never be used in patients who have a history of any of the following conditions:

  • Uncontrolled or severe high blood pressure (hypertension)
  • Patients who are receiving dialysis treatment
  • Major surgical procedures within the previous six weeks
  • Hemorrhagic stroke within 30 days or history of stroke
  • Bleeding problems
  • Active bleeding within the previous 30 days

Due to the slower removal of the drug from the body, this medication should be used with caution in patients who have kidney disease, as the risk of overdose is increased.

Storage

Eptifibatide solution is only used in hospitals and clinics. However, in rare circumstances it may be necessary for you to keep some in your home. In this case, the solution should be stored at room temperature. Keep the medication out of direct sunlight and away from heat sources. Do not freeze or refrigerate the drug.

Ensure that the drug is kept somewhere secure where it cannot be accessed by children or pets.

When the medication passes its use-by date or is no longer required, it should be disposed of correctly. Ask your pharmacist or GP for assistance in disposing of this drug.

Summary

Eptifibatide is given to patients in a hospital or clinic environment when they have undergone surgical procedures to the heart or blood vessels. The drug is an anticoagulant medicine that prevents the blood from forming clots that could block a blood vessel, potentially causing a serious embolism. This drug is also sometimes used as a preventative therapy in patients who may be vulnerable to suffering a heart attack.

There is a long list of medicines that should never be used at the same time as eptifibatide. In addition, there are some medical conditions that may be complicated by using this drug. For this reason, you should discuss your medical history in full with your doctor before you begin having treatment with this drug.

Eptifibatide can cause unusually persistent bleeding. While you are receiving this drug, you should take extra care not to cut yourself or sustain bruising. Attend your doctor for regular check-ups after you have been discharged from hospital so that the effects of the medication can be monitored and any side effects dealt with.