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| Drug class description : | GP IIb/IIIa inhibitors (antiplatelet agents). |
| Generic Name : | Tirofiban |
| Drug description : | Concentrate for solution for infusion. |
| Presentation : | Solution for infusion, tirofiban (as hydrochloride monohydrate) 0.25mg in 1mL of concentrate. |
| Indications : | Prevention of early myocardial infarction in patients presenting with unstable angina or non-Q- wave myocardial infarction with the last episode of chest pain occurring within 12 hours and with ECG changes and/or elevated cardiac enzymes. |
| Adult Dosage : | Dilute before use. See SPC. Administer resulting solution by intravenous infusion at an initial rate of 0.4microgram/kg/ minute for 30 minutes followed by a maintenance infusion rate of 0.1microgram/kg/minute. Aggrastat should be given with unfractionated heparin and acetylsalicyclic acid (see SPC for dosages). Recommended duration of infusion, not less than 48 hours. Infusion not less than 48 hours. Infusion may be continued during coronary angiography and should be maintained for at least 12 hours and not more than 24 hours after angioplasty/atherectomy. Entire duration of treatment should not exceed 108 hours. For hospital use only, by specialist physicians experienced in manangement of acute coronary syndromes. |
| Contra Indications : | Hypersensitivity to one of the constituents of the preparation or thrombocytopenia during earlier use of a GP IIb/IIIa receptor antagonist. History of stroke within 30 days or any history of haemorrhagic stroke; known history of intracranial disease (neoplasm, arteriovenous malformation, aneurysm); active or recent (within previous 30 days of treatment) clinically relevant bleeding (eg, gastrointestinal bleeding); malignant hypertension; relevant trauma or major surgical intervention within the past six weeks; thrombocytopenia (platelet count <100,000/mm3), disorders of platelet function; clotting disturbances (eg, prothrombin time >1.3 times normal or INR >1.5); severe liver failure. |
| Special Precautions : | Administration of Aggrastat alone without unfractionated heparin is not recommended. Efficacy and safety has not been investigated in combination with low molecular weight heparins. Monitor patients carefully for bleeding during treatment. See SPC for details of patient groups in whom tirofiban is not recommended because of a suspected increased risk of bleeding. Stop therapy immediately if thrombolytic therapy required or if patient requires emergency CABG operation or intra-aortic balloon pump. In cases of major or uncontrollable bleeding, tirofiban should be discontinued immediately. Use with special caution in the following conditions and patient groups: recent clinically year); puncture of a non- compressible vessel within 24 hours before administration of Aggrastat; severe, acute or chronic heart failure; cardiogenic shock; mild to moderate liver insufficiency; platelet count <150,000mm3, known history of platelet function disturbance or thrombocytopenia; haemoglobin concentration <11g/dL or haematocrit <34%. Higher incidence of bleeding complications observed in elderly patients and/or female patients, and patients with low bodyweight. Risk of bleeding increased with decreasing creatinine clearance; patients with impaired renal function should be monitored carefully for bleeding during treatment. Platelet count, haemoglobin and haematocrit levels should be determined before treatment and during treatment. Special caution should be used during concurrent administration of ticlopidine, clopidogrel, adenosine, dipyridamole, sulfinpyrazone (sulphinpyrazone), and prostacyclin. Determine activated thromboplastin time (APTT) before treatment with Aggrastat and monitor carefully the anticoagulant effects of heparin by repeated measurement of APTT. Pregnancy and lactation. |
| Interactions : | Ticlopidine, warfarin. Incompatible with diazepam and should not be administered in the same intravenous line. |
| Adverse Reactions : | Bleeding, GI, postoperative, intracranial or retroperitoneal bleeding, haemopericardium, epistaxis, gum bleeds, surface dermatorrhagia, haematoma, bleeding from catheter sites, decrease in platelet counts. Nausea, fever, headache, rash and urticaria. |
| Manufacturer : | MSD |
| Drug Availability : | (POM) |
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