Integrilin (Eptifibatide) Drug Information: Overdosage and Contraindications

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May 27, 2012

Integrilin

Deep Vein Thrombosis (DVT) »

Introduction to deep vein thrombosis (DVT)

Arteries have thin muscles within their walls to be able to withstand the pressure of the heart pumping blood to the far reaches of the body. Veins don't have a significant muscle lining, and there is nothing pumping blood back to the heart except physiology. Blood returns to the heart because the body's large muscles squeeze the veins as they contract in their normal activity of moving the body. The normal activities of moving the body returns the blood back to the heart.

There are two types of veins in the leg; superficial veins and deep veins. Superficial veins lie just below the skin and are easily seen on the surface. Deep veins, as their name implies, are located deep within the muscles of the leg. Blood flows from the superficial veins into the deep venous system through small perforator veins. Superficial and perforator veins have one-way valves within them that allow blood to flow only in the direc...

Read the Deep Vein Thrombosis (DVT) article »

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OVERDOSE

There has been only limited experience with overdosage of eptifibatide. There were 8 patients in the IMPACT II study, 9 patients in the PURSUIT study, and no patients in the ESPRIT study who received bolus doses and/or infusion doses more than double those called for in the protocols. None of these patients experienced an intracranial bleed or other major bleeding.

Eptifibatide was not lethal to rats, rabbits, or monkeys when administered by continuous intravenous infusion for 90 minutes at a total dose of 45 mg/kg (about 2- 5 times the recommended maximum daily human dose on a body surface area basis). Symptoms of acute toxicity were loss of righting reflex, dyspnea, ptosis, and decreased muscle tone in rabbits and petechial hemorrhages in the femoral and abdominal areas of monkeys.

From in vitro studies, eptifibatide is not extensively bound to plasma proteins and thus may be cleared from plasma by dialysis.

CONTRAINDICATIONS

Treatment with eptifibatide is contraindicated in patients with:

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. (See WARNINGS, Renal Insufficiency.)
Known hypersensitivity to any component of the product.

Last reviewed on RxList: 5/25/2011
This monograph has been modified to include the generic and brand name in many instances.