Aggrastat Dosage/Direction for Use

The vial of Aggrastat (concentrate) must be diluted prior to administration (see Instructions For Use as follows).
Aggrastat is for intravenous use only using sterile equipment. Aggrastat may be co-administered with heparin through the same line.
Aggrastat is recommended for use with a calibrated infusion device. Care should be taken to avoid a prolonged loading infusion. Care should also be taken in calculating the bolus dose and infusion rates based on patient weight.
In clinical studies, patients received aspirin, unless contraindicated.
Unstable Angina Pectoris or Non-Q-Wave Myocardial Infarction: Aggrastat should be administered intravenously, in combination with heparin, at the initial infusion rate of 0.4 μg/kg/min for 30 minutes. Upon completion of the initial infusion, Aggrastat should be continued at a maintenance infusion rate of 0.1 μg/kg/min. The table as follows is provided as a guide to dosage adjustment by weight (see Table 1).

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In the study that demonstrated efficacy, Aggrastat in combination with heparin was generally continued for a minimum of 48 hours and up to 108 hours on average, patients received Aggrastat for 71.3 hours. This infusion can be continued through angiography and should be continued up to 12 to 24 hours post-angioplasty/atherectomy. Arterial sheaths should be removed when the patient's activated clotting time is <180 seconds or 2-6 hours following cessation of heparin.
Angioplasty/Atherectomy: In patients in whom Aggrastat is initiated in the setting of angioplasty/atherectomy, Aggrastat should be administered intravenously, in combination with heparin, as an initial bolus of 10 μg/kg administered over 3 minutes followed by a maintenance infusion rate of 0.15 μg/kg/min. The table as follows is provided as a guide to dosage adjustment by weight (see Table 2).

Click on icon to see table/diagram/image

The Aggrastat maintenance infusion should be administered for 36 hours. Upon completion of the procedure, heparin should be discontinued and arterial sheaths should then be removed when the patient's activated clotting time is <180 seconds.
Patients with Severe Renal Insufficiency: As specified in the previous dosing tables, the dosage of Aggrastat should be decreased by 50% in patients with severe renal insufficiency (creatinine clearance <30 mL/min). (See Severe Renal Insufficiency under Precautions and Pharmacology: Pharmacokinetics: Characteristics in Patients, Renal Insufficiency under Actions.)
Other Patient Populations: No dosage adjustment is recommended for elderly patients (see Use in the Elderly under Precautions) or female patients.
Instructions For Use: Parenteral drug products should be inspected visually for particulate matter and discoloration prior to use, whenever solution and container permit.
The vial of Aggrastat (concentrate) must be diluted prior to administration (see as follows).
Directions for Preparation of Aggrastat Solution for Infusion from Concentrate: 1. Withdraw 50 mL from a 250 mL bag of sterile 0.9% saline or 5% dextrose in water and replace it with 50 mL of Aggrastat (from one 50 mL vial) to achieve a concentration of 50 μg/mL. Mix well before administration.
2. Administer according to the appropriate dosage adjustments by weight previously mentioned.
3. Any unused intravenous solution should be discarded after 24 hours.
Aggrastat may be administered in the same intravenous line as atropine sulfate, dobutamine, dopamine, epinephrine HCl, furosemide, lidocaine, midazolam HCl, morphine sulfate, nitroglycerin, potassium chloride, propranolol HCl and famotidine IV injection. Aggrastat should not be administered in the same intravenous line as diazepam.