Uses of Integril: - Heart attack Myocardial infarction, Unstable angina, Angioplasty, Percutaneous coronary intervention (PCI) Active bleeding, increased risk of haemorrhage including hemorrhagic disorders, cerebrovascular disorders, history of stroke, uncontrolled hypertension, severe trauma, severe renal impairment, recent major surgery. Lactation.

Anti-platelet drugs

Eptifibatide is a cyclic heptapeptide containing six amino acids and one mercaptopropionyl (des-amino cysteinyl) residue. Integril binds to the platelet receptor glycoprotein (GP) IIb/IIIa of human platelets and reversibly inhibits platelet aggregation by preventing the binding of fibrinogen, von Willebrand factor, and other adhesive ligands to GP IIb/IIIa.

How to use Eptifibatide: Your doctor or nurse will give you this medicine. Kindly do not self administer. Adult Dose: Intravenous Unstable angina Adult: 180 mcg/kg via IV inj followed by 2 mcg/kg per minute by IV infusion for up to 72 hr. If percutaneous coronary intervention (PCI) is performed during therapy, infusion should be continued for 18-24 hr after procedure, up to a maximum total duration of 96 hr of therapy. Angioplasty Adult: Initially, 180 mcg/kg via IV inj, to be given immediately before procedure, followed by 2 mcg/kg/minute via IV infusion. A second dose of 180 mcg/kg via IV inj should be given 10 minutes after the 1st dose. Continue infusion until hospital discharge or for up to 18-24 hr (minimum treatment duration: 12 hr). Renal Dose: Renal Impairment (CrCl <50 mL/min) ACS: 180 mcg/kg IV, THEN continuous infusion 1 mcg/kg/min PCI: 180 mcg/kg IV, THEN continuous infusion 1 mcg/kg/min with another 180 mcg/kg IV bolus 10 minutes after 1st one Hemodialysis: Safety and using during hemodialysis not established

Increased risk of bleeding w/ heparin, other anticoagulants, antiplatelet & thrombolytic agents.

Active bleeding, increased risk of haemorrhage including hemorrhagic disorders, cerebrovascular disorders, history of stroke, uncontrolled hypertension, severe trauma, severe renal impairment, recent major surgery. Lactation.

Common - Bleeding - Decreased blood pressure 1-10% Bleeding (8%),Hypotension (7%),Thrombocytopenia (2.3%),Injection site reaction <1% Hypersensitivity,Intracranial hemorrhage,Pulmonary hemorrhage,Thrombocytopenia,GI hemorrhage

Pregnancy: Category B. Animal studies revealed no evidence of harm to the fetus due to Integril. There are, however, no adequate and well-controlled studies in pregnant women with Integril. Lactating Mothers: It is not known whether Integril is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Integril is administered to a nursing mother.

Precaution: Discontinue in case of serious uncontrolled bleeding, or if emergency surgery or thrombolytic therapy is required. Hepatic impairment, platelet counts <100,000 mm3; hemorrhagic retinopathy, drugs affecting haemostasis. Check APTT or ACT prior to sheath removal. Severe renal impairment, vasculitis, haemorrhagic retinopathy, acute pericarditis or aortic dissection. Pregnancy. Lactation: excretion in milk unknown; use with caution

• There has been only limited experience with overdosage of Integril. Symptoms of acute toxicity were loss of righting reflex, dyspnea, ptosis, and decreased muscle tone in rabbits, and petechial hemorrhages in the femoral and abdominal areas of monkeys. • From in vitro studies, eptifibatide is not extensively bound to plasma proteins and thus may be cleared from plasma by dialysis.

• Vials should be stored refrigerated at 2-8° C• Vials may be transferred to room temperature storage for up to 2 months.• Unused portion left in the vial should be discarded. • Vials should be protected from light until administration.

Anti-platelet drugs

Eptifibatide is a cyclic heptapeptide which blocks the platelet glycoprotein IIb/IIIa receptor thus preventing platelet aggregation and thrombosis.

Pregnancy Category: B Lactation: excretion in milk unknown; use with caution