Eptifibatide Clopidogrel

Tirofiban and eptifibatide are also indicated in patients with continued or recurrent ischemia despite treatment with aspirin, clopidogrel, and an anticoagulant. 

Without clopidogrel Abciximab, eptifibatide, or tirofiban (L0E A) in high-risk patients... 

Eptifibatide (Integrelin), a cyclic heptapeptide based on a peptide sequence in snake venom, is a GPIIb/llla inhibitor used in conjunction with heparin and aspirin for the treatment of ACS or in PCI, with or without stenting and clopidogrel (Table I). 

I 9 Gurbel PA, Bliden KB Zaman KA, Yoho JA, Hayes KM, Tantry US. Clopidogrel loading with eptifibatide to arrest the reactivity of platelets results of the clopidogrel loading with eptifibatide to arrest the reactivity of platelets (CLEAR PLATELETS) study. Circulation 2005 I I I I I 53-1 I 59. 

Gurbel PA, Bliden KB Tantry US. The effect of clopidogrel with and without eptifibatide on tumor necrosis factor-alpha and C-reactive protein release after elective stenting Results of the CLEAR PLATELETS-lb study. J Am Coll Cardiol 2006 48 2186-2191. 

Case Conclusion Despite treatment with nitroglycerin, metoprolol, and heparin drips in the ED, PB continued to have chest pain. He was scheduled for an emergent coronary catheterization to improve symptoms and prevent further ischemia. He was started on an eptifibatide IV drip for 24 hours and oral clopidogrel for 4 weeks. 

Clinically important, potentially hazardous interactions with abciximab, anagrelide, anticoagulants, cilostazol, clopidogrel, dabigatran, dipyridamole, eptifibatide, salicylates, ticlopidine, tirofiban. Many herbals that possess anticoagulant or antiplatelet activity... 

Caution must be employed when eptifibatide is used with other drugs that affect haemostasis, including clopidogrel, ticlopidine, dipyridamole, oral anticoagulants or thrombolytics and concurrent or planned use of another glycoprotein Ilb/IIIa inhibitor is contraindicated. ... 

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