What Is Abciximab and How Does It Work?
Abciximab is a prescription medication used for the prevention of unstable angina or cardiac complications in people undergoing PCI.
- Abciximab is available under the following different brand names: ReoPro
What Are Dosages of Abciximab?
Adjunct to PCI
- 0.25 mg/kg IV bolus over at least 1 min, 10-60 min before the start of PCI, THEN
- 0.125 mcg/kg/min IV continuous infusion for 12 hours; not to exceed infusion rate of 10 mcg/min .
- 0.25 mg/kg IV bolus over at least 1 minute, THEN
- 0.125 mcg/kg/min IV continuous infusion for 18-24 hr concluding 1 hour post-PCI; not to exceed 10 mcg/min
Dosage Considerations – Should be Given as Follows:
- See “Dosages”
What Are Side Effects Associated with Using Abciximab?
Common side effects of the Abciximab include:
- injection site reactions (bleeding, irritation, or pain),
- back pain,
- changes in vision,
- stomach upset,
- abdominal pain,
- low blood pressure,
- slow heart rate,
- chest pain,
- swelling of the extremities, or
- mood changes.
Serious side effects of the Abciximab include:
Rare side effects of the Abciximab include:
This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.
What Other Drugs Interact with Abciximab?
If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.
- Abciximab has severe interactions with the following drug:
- Abciximab has serious interactions with the following drugs:
- Abciximab has moderate interactions with at least 20 other drugs.
- Abciximab has minor interactions with the following drugs:
This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.
What Are Warnings and Precautions for Abciximab?
- Active internal bleeding
- Recent (within six weeks) gastrointestinal (GI) or genitourinary (GU) bleeding of clinical significance
- History of CVA (within 2 years) or CVA with a significant residual neurological deficit
- Bleeding diathesis
- Administration of oral anticoagulants within seven days unless prothrombin time is less than 1.2 times control
- Thrombocytopenia (lower than 100,000 cells/μL)
- Recent (within six weeks) major surgery or trauma
- Intracranial neoplasm, arteriovenous malformation, or aneurysm
- Severe uncontrolled hypertension
- Presumed or documented history of vasculitis
Effects of drug abuse
- See “What Are Side Effects Associated with Using Abciximab?”
- See “What Are Side Effects Associated with Using Abciximab?”
- Intended for use with aspirin and heparin, and has only been studied in that setting
- Allergic reactions, some of which were anaphylaxis (sometimes fatal), are reported rarely in patients receiving therapy; patients with allergic reactions should receive appropriate treatment; treatment of anaphylaxis should include immediate discontinuation of therapy and initiation of resuscitative measures
- In the event of serious uncontrolled bleeding or need for emergency surgery, therapy should be discontinued; if platelet function does not return to normal, it may be restored, at least in part, with platelet transfusions
- Bleeding events
- Has the potential to increase the risk of bleeding events, rarely including those with a fatal outcome, particularly in presence of anticoagulation, eg, from heparin, other anticoagulants, or thrombolytics
- The risk of major bleeds due to therapy is increased in patients receiving thrombolytic and should be weighed against anticipated benefits
- Should serious bleeding occur that is not controllable with pressure, the infusion of this medication and any concomitant heparin should be stopped
- Bleeding precautions
- To minimize the risk of bleeding, important to use a low-dose, weight-adjusted heparin regimen, a weight-adjusted Abciximab bolus and infusion, strict anticoagulation guidelines, careful vascular access site management, discontinuation of heparin after the procedure, and early femoral arterial sheath removal
- Therapy requires careful attention to all potential bleeding sites including catheter insertion sites, arterial and venous puncture sites, cutdown sites, needle puncture sites, and gastrointestinal, genitourinary, pulmonary (alveolar), and retroperitoneal sites
- Arterial and venous punctures, intramuscular injections, and the use of urinary catheters, nasotracheal intubation, nasogastric tubes, and automatic blood pressure cuffs should be minimized
- When obtaining intravenous access, non-compressible sites (e.g., subclavian or jugular veins) should be avoided; saline or heparin locks should be considered for blood drawing; vascular puncture sites should be documented and monitored; gentle care should be provided when removing dressings
- Arterial access site care is important to prevent bleeding; care should be taken when attempting vascular access that only the anterior wall of the femoral artery is punctured, avoiding a Seldinger (through and through) technique for obtaining sheath access
- Femoral vein sheath placement should be avoided unless needed; while the vascular sheath is in place, patients should be maintained on complete bed rest with the head of the bed less than 30°and affected limbs restrained in a straight position; patients may be medicated for back/groin pain as necessary
- Discontinuation of heparin immediately upon completion of procedure and removal of the arterial sheath within six hours is strongly recommended if APTT is less than 50 sec or ACT is less than 175 sec; in all circumstances, heparin should be discontinued at least two hours before arterial sheath removal
- Following sheath removal, pressure should be applied to the femoral artery for at least 30 minutes using either manual compression or a mechanical device for hemostasis; a pressure dressing should be applied following hemostasis; the patient should be maintained on bed rest for six to eight hours following sheath removal or discontinuation of therapy, or four hours following discontinuation of heparin, whichever is later
- The pressure dressing should be removed before ambulation; the sheath insertion site and distal pulses of affected leg(s) should be frequently checked while the femoral artery sheath is in place and for six hours after femoral artery sheath removal; any hematoma should be measured and monitored for enlargement
- The following conditions have been associated with an increased risk of bleeding and may be additive with the effect of therapy in the angioplasty setting: PCI within 12 hr of the onset of symptoms for acute myocardial infarction, prolonged PCI (lasting more than 70 minutes) and failed PCI
- Use of thrombolytics, anticoagulants, and other antiplatelet agents
- Because drug inhibits platelet aggregation, caution should be employed when it is used with other drugs that affect hemostasis, including thrombolytics, oral anticoagulants, non-steroidal anti-inflammatory drugs, dipyridamole, and ticlopidine
- Because of observed synergistic effects on bleeding, therapy should be used judiciously in patients who have received systemic thrombolytic therapy
- Thrombocytopenia, including severe thrombocytopenia, reported with therapy
- Monitor platelet counts before, during, and after treatment
- Acute decreases in platelet count should be differentiated between true thrombocytopenia and pseudothrombocytopenia
- If true thrombocytopenia is verified, therapy should be immediately discontinued, and the condition appropriately monitored and treated
Pregnancy and Lactation
- Use with caution if benefits outweigh risks during pregnancy
- Not known if excreted in breast milk; use caution.