Zuellig Pharma
Concise Prescribing Info
Tirofiban HCl
In combination w/ heparin for patients w/ unstable angina or non-Q-wave MI to prevent cardiac ischemic events & for patients w/ coronary ischemic syndromes undergoing coronary angioplasty or atherectomy to prevent cardiac ischemic complications related to abrupt closure of the treated coronary artery.
Dosage/Direction for Use
Dilute prior to administration. Unstable angina pectoris or non-Q-wave MI Co-administer w/ heparin at initial infusion rate of 0.4 mcg/kg/min for 30 min. Continue at maintenance infusion rate of 0.1 mcg/kg/min, for min of 48 hr & up to 108 hr. Infusion can be continued through angiography & should be continued up to 12-24 hr post-angioplasty/atherectomy. Remove arterial sheaths when the patient's activated clotting time is <180 sec or 2-6 hr following cessation of heparin. Angioplasty/atherectomy Co-administer w/ heparin, as initial bolus of 10 mcg/kg over 3 min followed by maintenance infusion rate of 0.15 mcg/kg/min for 36 hr. Upon completion of procedure, heparin should be discontinued & remove arterial sheaths when the patient's activated clotting time is <180 sec.
Hypersensitivity. Active internal bleeding, history of intracranial hemorrhage, intracranial neoplasm, arteriovenous malformation or aneurysm. Patients who developed thrombocytopenia following prior exposure to Aggrastat.
Special Precautions
Recent (<1 yr) bleeding including history of GI or genitourinary bleeding of clinical significance. Known coagulopathy, platelet disorder or history of thrombocytopenia; platelet count <150,000 cells/mm3. History of cerebrovascular disease w/in 1 yr; major surgical procedure or severe physical trauma w/in 1 mth; recent epidural procedure. History, symptoms or findings suggestive of aortic dissection; severe uncontrolled HTN (systolic BP >180 mmHg &/or diastolic BP >110 mmHg). Acute pericarditis. Hemorrhagic retinopathy. Chronic haemodialysis. Caution w/ other drugs affecting hemostasis. Associated w/ minor increases in bleeding rates particularly at the site of arterial access for femoral sheath placement. Care should be taken when attempting vascular access that only the anterior wall of the femoral artery is punctured, avoiding Seldinger (through & through) technique for obtaining sheath access. Care should be taken to obtain proper hemostasis after removal of sheaths followed by close observation. Monitor platelet counts, Hb & hematocrit prior to treatment, w/in 6 hr following bolus or loading infusion & at least daily thereafter during therapy. Consider earlier monitoring of platelet count in patients who have previously received GP IIb/IIIa receptor antagonists. Determine aPTT before treatment & monitor anticoagulant effects of heparin. Potentially life-threatening bleeding may occur especially when heparin is administered w/ other products affecting hemostasis eg, GP IIb/IIIa receptor antagonists. Severe renal insufficiency (CrCl <30 mL/min). Pregnancy & lactation. Childn.
Adverse Reactions
Bleeding (intracranial bleeding, retroperitoneal bleeding); decreased platelet counts; nausea, fever & headache.
Drug Interactions
Heparin & aspirin, other drugs affecting hemostasis (eg, warfarin).
MIMS Class
Anticoagulants, Antiplatelets & Fibrinolytics (Thrombolytics)
ATC Classification
B01AC17 - tirofiban ; Belongs to the class of platelet aggregation inhibitors excluding heparin. Used in the treatment of thrombosis.
Aggrastat concentration for infusion 0.25 mg/mL
50 mL x 1's
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