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Tirofiban (Aggrastat)
Tradename: Aggrastat.
Indications:
- adjunctive agent with angioplasty (PTCA)*
- may be useful for acute coronary syndrome
- without persistent ST segment elevation [2]
* reserved for use at the time of percutaneous coronary intervention [3]
Infusion:
1) bolus: 10 ug/kg over 3 minutes
2) infusion: 0.15 ug/kg/min
a) also heparin bolus 10,000 U or 150 U/kg if < 70 kg
b) mean duration of infusion 71 hours (Prism-Plus trial)
Contraindications:
1) active internal bleeding
2) intracranial pathology
a) intracranial hemorrhage
b) intracranial neoplasm
c) arteriovenous malformation
d) aneurysm
3) systolic blood pressure > 180 mm Hg
4) diastolic blood pressure > 110 mm Hg
5) acute pericarditis
6) history of stroke
a) any history of hemorrhagic stroke
b) history of ischemic stroke within last 30 days
7) major surgical procedure or severe trauma within the last 30 days
Adverse effects:
1) bleeding 17%
2) pelvic pain 6%
3) coronary artery dissection 5%
4) bradycardia 4%
Mechanism of action:
-> inhibits glycoprotein IIb/IIIa receptor
Interactions
drug interactions
drug adverse effects (more general classes)
Related
angioplasty; balloon angioplasty
glycoprotein IIB/IIIA
General
amine
glycoprotein IIb/IIIa inhibitor
Properties
SIZE: MW = 458.6 G/M
MISC-INFO: 1/2life 2 HOURS
Database Correlations
PUBCHEM correlations
References
- Merk & Co. package insert
- Journal Watch 22(6):47, 2002
Boersma E et al, Lancet 359:189, 2002
- Medical Knowledge Self Assessment Program (MKSAP) 19
American College of Physicians, Philadelphia 2022