Monograph Details
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Hematology
> Thromboembolic disorders
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AGGRASTAT |
| Manufacturer |
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MGI Pharma, Inc. |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Antiplatelet (GP IIb/IIIa blocker). |
| Generic Name |
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Tirofiban (as HCl monohydrate) 50micrograms/mL for IV infusion or 250micrograms/mL for IV infusion after dilution; preservative-free. |
| Indications |
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Combined with heparin for acute coronary syndrome, including patients who are to be managed medically and those undergoing percutaneous transluminal coronary angioplasty or atherectomy. |
| Children |
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<18 yrs: not recommended. |
| Adults |
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See literature. Dilute concentrate before using. ≥18yrs: initial rate 0.4micrograms/kg per minute for 30 minutes then 0.1micrograms/kg per minute. Severe renal insufficiency (CrCl <30mL/min): reduce rate by ½. Stop infusion if bleeding cannot be controlled by pressure. |
| Contraindications |
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Within previous 30 days: active internal bleeding, bleeding diathesis, stroke, major surgery, or severe trauma. History of intracranial hemorrhage, intracranial neoplasm, arteriovenous malformation, aneurysm, or hemorrhagic stroke. History of thrombocytopenia after previous tirofiban therapy. History, symptoms, or findings suggestive of aortic dissection. Severe hypertension. Acute pericarditis. Concomitant other parenteral GP IIb/IIIa blockers. |
| Precautions |
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Platelet count <150,000/mm3. Hemorrhagic retinopathy. Chronic hemodialysis. Properly care for femoral artery access site to minimize bleeding (document activated clotting time <180sec or aPTT <45sec and stop heparin before pulling sheath). Minimize other arterial and venous punctures, IM injections, catheter use, intubation, etc. to minimize bleeding risk; avoid use of non-compressible IV access sites. Do baseline platelet counts, hemoglobin, hematocrit and monitor during therapy (see literature). Discontinue if confirmed thrombocytopenia occurs. Adjust heparin to maintain aPTT at 2x control. Severe renal insufficiency. Pregnancy (Cat.B). Nursing mothers: not recommended. |
| Interactions |
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See Contraindications. Increased bleeding with heparin and aspirin; caution with these and others that affect hemostasis. Levothyroxine, omeprazole may increase clearance of tirofiban. |
| Adverse Reactions |
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Bleeding (may be fatal), decreased hemoglobin +/or hematocrit, reduced platelet counts, edema, vasovagal reaction, anaphylaxis. |
| How Supplied |
Premixed 50micrograms/mL (250mL)—1
Concentrate 250micrograms/mL (50mL)—1 |
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