Integril
Cheaper & Alternative Brands
Same generic (Eptifibatide), same form (IV Injection)
Clinical Prescribing Information
Medical monograph and safety information for healthcare professionals & patients.Indications & Clinical Uses
Integril is indicated in-
Patients with acute coronary syndrome (unstable angina/non-ST- segment elevation myocardial infarction), including patients who are to be managed medically and those undergoing percutaneous coronary intervention (PCI).
Patients undergoing PCI, including those undergoing intracoronary stenting.
Contraindications
A history of bleeding diathesis, or evidence of active abnormal bleeding within the previous 30 days.
Severe hypertension (systolic blood pressure >200 mm Hg or diastolic blood pressure >110 mm Hg) not adequately controlled on antihypertensive therapy.
Major surgery within the preceding 6 weeks.
History of stroke within 30 days or any history of hemorrhagic stroke.
Current or planned administration of another parenteral GP IIb/IIIa inhibitor.
Dependency on renal dialysis.
Known hypersensitivity to any component of the product.
Side Effects & Adverse Reactions
Bleeding is the most common adverse effect. Adverse reactions include intracranial hemorrhage and stroke, thrombocytopenia, allergic reactions and hypotension.
Warnings & Precautions
In patients undergoing PCI, Integril Injection is associated with an increase in major and minor bleeding at the site of arterial sheath placement. Special care should be employed to minimize the risk of bleeding among these patients.
If bleeding cannot be controlled with pressure, infusion of Integril and concomitant heparin should be stopped immediately.
Because Integril inhibits platelet aggregation, caution should be employed when it is used with drugs that affect hemostasis, including thrombolytics, oral anticoagulants, NSAIDs, and dipyridamole.
Use with other GP IIb-IIIa inhibitors should be avoided.
Integril is cleared in part by the kidney and its plasma concentrations are doubled in patients with renal disease (creatinine clearance <50 ml/min). Therefore, the infusion dose of Integril needs to be reduced to 1 mcg/kg/min in these patients. Integril is contraindicated in patients who are dependent upon renal dialysis.
Caution should be exercised when administering Integril to patients with a platelet count <100,000/mm3.
Bleeding is the most common complication encountered during Integril therapy. The majority of excess major bleeding events were localized at the femoral artery access site. Oropharyngeal, genitourinary, gastrointestinal, and retroperitoneal bleeding were seen more commonly with Integril compared with placebo.
Arterial and venous punctures, intramuscular injections, and the use of urinary catheters, nasotracheal intubation, and nasogastric tubes should be minimized. When obtaining intravenous access, noncompressible sites (e.g., subclavian or jugular veins) should be avoided.
Before infusion of Integril, the following laboratory tests should be performed to identify preexisting hemostatic abnormalities: hematocrit or hemoglobin, platelet count, serum creatinine, and PT/aPTT. In patients undergoing PCI, the activated clotting time (ACT) should also be measured.
Pharmacology & Mechanism of Action
Eptifibatide is indicated-
For the treatment of patients with acute coronary syndrome (unstable angina/non-ST-segment elevation myocardial infarction), including patients who are to be managed medically and those undergoing percutaneous coronary intervention (PCI).
For the treatment of patients undergoing PCI, including those undergoing intracoronary stenting.