Tirofiban

What is Tirofiban

Tirofiban is a synthetic non-peptide platelet glycoprotein IIb/IIIa inhibitor approved for rate reduction of thrombotic cardiovascular events in patients with non-ST elevation acute coronary syndromes.

Inhibition of the platelet glycoprotein IIb/IIIa receptor prevents platelet aggregation.

Tirofiban has a low molecular weight and little, if any, immunogenicity.

When administered at the recommended dosage, > 90% inhibition of platelet aggregation is attained within 10 minutes, and platelet aggregation reverses within 4—8 hours of drug discontinuation.

Tirofiban was FDA-approved in May 1998.

Brand Name

Aggrastat

Indications

  1. acute myocardial infarction, NSTEMI
  2. acute myocardial infarction, STEMI
  3. coronary artery disease
  4. unstable angina

To reduce the rate of thrombotic cardiovascular events (combined endpoint of death, myocardial infarction, or refractory ischemia/repeat cardiac procedure) in patients with non-ST elevation acute coronary syndromes including acute myocardial infarction, NSTEMI and unstable angina

Side Effects

  1. anaphylactoid reactions
  2. bleeding
  3. bradycardia
  4. chills
  5. dizziness
  6. edema
  7. fever
  8. GI bleeding
  9. headache
  10. hematemesis
  11. hematoma
  12. hematuria
  13. hemoptysis
  14. hyperhidrosis
  15. hypotension
  16. intracranial bleeding
  17. nausea
  18. pelvic pain
  19. platelet dysfunction
  20. rash
  21. retroperitoneal bleeding
  22. thrombocytopenia
  23. urticaria
  24. vomiting

Monitoring Parameters

  • activated partial thromboplastin time (APTT)
  • clotting time
  • hemoglobin/hematocrit
  • platelet count
  • serum creatinine/BUN
  • thrombin time

Contraindications

  • aneurysm
  • anticoagulant therapy
  • aortic dissection
  • arteriovenous malformation
  • bleeding
  • breast-feeding
  • coagulopathy
  • dialysis
  • epidural anesthesia
  • geriatric
  • hypertension
  • intracranial bleeding
  • intracranial mass
  • intramuscular injections
  • lumbar puncture
  • pericarditis
  • pregnancy
  • renal disease
  • renal failure
  • renal impairment
  • spinal anesthesia
  • stroke
  • surgery
  • thrombocytopenia
  • thrombolytic therapy
  • trauma
  • venipuncture

Interactions

  • Acetaminophen; Aspirin, ASA; Caffeine
  • Ado-Trastuzumab emtansine
  • ADP receptor antagonists
  • Altretamine
  • Aminolevulinic Acid
  • Amoxicillin; Clarithromycin; Omeprazole
  • Anagrelide
  • Antimetabolites
  • Antithrombin III
  • Antithymocyte Globulin
  • Apixaban
  • Argatroban
  • Aspirin, ASA
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Citric Acid; Sodium Bicarbonate
  • Aspirin, ASA; Dipyridamole
  • Aspirin, ASA; Omeprazole
  • Aspirin, ASA; Oxycodone
  • Aspirin, ASA; Pravastatin
  • Betrixaban
  • Bexarotene
  • Bivalirudin
  • Chlorambucil
  • Cilostazol
  • Cladribine
  • Clofarabine
  • Collagenase
  • Dabigatran
  • Dalteparin
  • Danaparoid
  • Danazol
  • Defibrotide
  • Denileukin Diftitox
  • Desirudin
  • Desvenlafaxine
  • Dipyridamole
  • Drotrecogin Alfa
  • Duloxetine
  • Edoxaban
  • Enoxaparin
  • Estramustine
  • Fish Oil, Omega-3 Fatty Acids (Dietary Supplements)
  • Fludarabine
  • Folate analogs
  • Fondaparinux
  • Garlic, Allium sativum
  • Ginger, Zingiber officinale
  • Ginkgo, Ginkgo biloba
  • Green Tea
  • Heparin
  • Ibritumomab Tiuxetan
  • Ibrutinib
  • Icosapent ethyl
  • Iloprost
  • Imatinib
  • Inotersen
  • Intravenous Lipid Emulsions
  • Lepirudin
  • Levomilnacipran
  • Levothyroxine
  • Levothyroxine; Liothyronine (Porcine)
  • Levothyroxine; Liothyronine (Synthetic)
  • Lomustine, CCNU
  • Mercaptopurine, 6-MP
  • Methoxsalen
  • Methylsulfonylmethane, MSM
  • Milnacipran
  • Mycophenolate
  • Nelarabine
  • Nonsteroidal antiinflammatory drugs
  • Obinutuzumab
  • Omeprazole
  • Omeprazole; Amoxicillin; Rifabutin
  • Omeprazole; Sodium Bicarbonate
  • Pegaspargase
  • Pentosan
  • Pentostatin
  • Pentoxifylline
  • Phentermine; Topiramate
  • Photosensitizing agents (topical)
  • Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
  • Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
  • Purine analogs
  • Rivaroxaban
  • Selective serotonin reuptake inhibitors
  • Selumetinib
  • Sodium Hyaluronate, Hyaluronic Acid
  • Sulfinpyrazone
  • Thioguanine, 6-TG
  • Thrombolytic Agents
  • Tinzaparin
  • Tipranavir
  • Topiramate
  • Treprostinil
  • Tretinoin, ATRA
  • Venlafaxine
  • Verteporfin
  • Vilazodone
  • Vorapaxar
  • Vortioxetine
  • Warfarin
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