Classifications: anticoagulant; antiplatelet agent; glycoprotein iib/iiia receptor inhibitor; Therapeutic: antiplatelet
Pregnancy Category: B
250 mcg/mL, 50 mcg/mL injection
Antiplatelet agent that binds to the glycoprotein IIb/IIIa receptor of platelets inhibiting platelet aggregation.
Effectiveness indicated by minimizing thrombotic events during treatment of acute coronary syndrome.
Acute coronary syndromes (unstable angina, MI).
Active internal bleeding within 30 d; acute pericarditis; aortic dissection; intracranial aneurysm, intracranial mass, coagulopathy;
concurrent use with another glycoprotein IIb/IIIa receptor inhibitor (e.g., eptifibatide, abciximab), or heparin; history
of aneurysm or AV malformation; history of intracranial hemorrhage or neoplasm; hypersensitivity to tirofiban; active abnormal
bleeding; retinal bleeding; hemorrhagic retinopathy; major surgery or trauma within 3 d; stroke within 30 d; history of
hemorrhagic stroke; thrombocytopenia following administration of tirofiban; within 4 h of percutaneous coronary intervention
Concomitant use with thrombolytic agents or drugs that cause hemolysis; platelet count <150,000 mm3; severe renal insufficiency; pregnancy (category B). Safety and efficacy in children <18 y are unknown.
Route & Dosage
|Acute Coronary Syndromes
Adult: IV 0.4 mcg/kg/min for 30 min, then 0.1 mcg/kg/min for 1224 h after angioplasty or arteriectomy
Clcr <30 mL/min: reduce rate of infusion 50%
PREPARE: IV Infusion: Withdraw 100 mL from a 500-mL bag of NS or D5W and replace with 100 mL of tirofiban HCl injection. If a 250-mL IV bag is
used, withdraw 50 mL of IV solution and replace with 50 mL of tirofiban injection. Either preparation yields 50 mcg/mL.
Mix well before infusing. Note: Commercially premixed IV tirofiban solutions are available.
ADMINISTER: IV Infusion: An initial loading dose of 0.4 mcg/kg/min for 30 min is usually followed by a maintenance infusion of 0.1 mcg/kg/min.
INCOMPATIBILITIES Y-site: Diazepam, tenecteplase.
- Discard unused IV solution 24 h following start of infusion.
- Store unopened containers at 15°30° C (59°86° F). Do not freeze and protect from light.
Adverse Effects (≥1%) Body as a Whole:
Edema, swelling, pelvic pain, vasovagal reaction, leg pain. CNS:
Bradycardia, coronary artery dissection. GI:
GI bleeding. Hematologic: Bleeding
), anemia, thrombocytopenia. Skin:
Increased risk of bleeding with anticoagulants
, antiplatelet agents
. Herbal: Feverfew, garlic, ginger, ginkgo, horse chestnut
may increase risk of bleeding.
48 h after stopping infusion. Distribution:
65% protein bound. Metabolism:
Minimally metabolized. Elimination:
65% in urine, 25% in feces. Half-Life:
Assessment & Drug Effects
- Lab tests: Monitor platelet count, Hgb and Hct before treatment, (within 6 h of infusing loading dose), and frequently throughout
treatment; monitor aPTT and ACT.
- Withhold drug and notify physician if thrombocytopenia (platelets <100,000) is confirmed.
- Monitor carefully for and immediately report S&S of internal or external bleeding.
- Wait at least 34 h after heparin is stopped and until ACT <180 sec and aPPT <45 sec before removing the femoral catheter
- Minimize unnecessary invasive procedures and devices to reduce the risk of bleeding.
Patient & Family Education
- Report unexplained pelvic or abdominal pain.