Drug reference

Tirofiban

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 245, 246

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

In combination with unfractionated heparin, aspirin, and clopidogrel for prevention of early myocardial infarction in patients with unstable angina or non-ST-segment- elevation myocardial infarction (NSTEMI) and with last episode of chest pain within 12 hours (with angiography planned for 4–48 hours after diagnosis) (initiated under specialist supervision) ▶BY INTRAVENOUS INFUSION ▶Adult: Initially 400 nanograms/kg/minute for 30 minutes, then 100 nanograms/kg/minute for at least 48 hours (continue during and for 12–24 hours after percutaneous coronary intervention), maximum duration of treatment 108 hours In combination with unfractionated heparin, aspirin, and clopidogrel for prevention of early myocardial infarction in patients with unstable angina or non-ST-segment- elevation myocardial infarction (NSTEMI) and with last episode of chest pain within 12 hours (with angiography within 4 hours of diagnosis) (initiated under specialist supervision) ▶INITIALLY BY INTRAVENOUS INJECTION ▶Adult: 25 micrograms/kg, to be given over 3 minutes at start of percutaneous coronary intervention, then (by intravenous infusion) 150 nanograms/kg/minute for 12–24 hours, maximum duration of treatment 48 hours continued → In combination with unfractionated heparin, aspirin, and clopidogrel for reduction of major cardiovascular events in patients with ST-segment elevation myocardial infarction (STEMI) intended for primary percutaneous Cardiovascular system coronary intervention (PCI) (initiated under specialist supervision) ▶INITIALLY BY INTRAVENOUS INJECTION ▶Adult: 25 micrograms/kg, to be given over 3 minutes at start of percutaneous coronary intervention, then (by intravenous infusion) 150 nanograms/kg/minute for 12–24 hours, maximum duration of treatment 48 hours

PDF pages 245, 246

Contra Indications

Abnormal bleeding within 30 days. history of haemorrhagic stroke. history of intracranial disease. increased INR. increased prothrombin time. severe hypertension. stroke within 30 days. thrombocytopenia

PDF page 246

Cautions

Active peptic ulcer (within 3 months). acute pericarditis. anaemia. aortic dissection. cardiogenic shock . discontinue if intra-aortic balloon pump necessary. discontinue if thrombolytic therapy necessary. discontinue immediately if serious or uncontrollable bleeding occurs. discontiue if emergency cardiac surgery necessary. elderly. faecal occult blood. haematuria. haemorrhagic retinopathy. low body-weight. major surgery within 3 months (avoid if within 6 weeks). organ biopsy or lithotripsy within last 2 weeks. puncture of non- compressible vessel within 24 hours. risk of bleeding (within 3 months). severe heart failure. severe trauma within 3 months (avoid if within 6 weeks). traumatic or protracted cardiopulmonary resuscitation within last 2 weeks. uncontrolled severe hypertension. vasculitis

PDF page 246

Safety

Interactions

→Appendix 1: tiroﬁban

PDF page 246

Side Effects

▶Common or very common Ecchymosis. fever. haemorrhage . headache. nausea. thrombocytopenia ▶Frequency not known Intracranial haemorrhage

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Pregnancy

Manufacturer advises use only if potential beneﬁt outweighs risk—no information available.

PDF page 246

Breast Feeding

Manufacturer advises avoid—no information available.

PDF page 246

Hepatic Impairment

Manufacturer advises caution in mild to moderate hepatic failure; avoid in severe hepatic failure (no information available).

PDF page 246

Renal Impairment

Increased risk of bleeding. Dose adjustments Use half normal dose if eGFR less than 30 mL/minute/1.73 m2. Monitoring Monitor carefully if eGFR less than 60 mL/minute/1.73 m2.

PDF page 246

Monitoring Requirements

Monitor platelet count, haemoglobin and haematocrit before treatment, 2–6 hours after start of treatment and then at least once daily.

PDF page 246

Dose and formulations

Directions For Administration

For intravenous infusion (Aggrastat ®), give continuously in Glucose 5% or Sodium chloride 0.9%. Withdraw 50 mL infusion ﬂuid from 250 mL bag and replace with 50 mL tiroﬁban concentrate (250 micrograms/mL) to give a ﬁnal concentration of 50 micrograms/mL.

PDF page 246

Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Solution for infusion ELECTROLYTES: May contain Sodium ▶Aggrastat (Correvio UK Ltd) Tirofiban 250 microgram per 1 ml Aggrastat 12.5mg/50ml concentrate for solution for infusion vials | 1 vial P £146.11 (Hospital only) Infusion ELECTROLYTES: May contain Sodium ▶Tirofiban (Non-proprietary) Tirofiban 50 microgram per 1 ml Tirofiban 12.5mg/250ml infusion bags | 1 bag P £159.00–£160.72 (Hospital only) ▶Aggrastat (Correvio UK Ltd) Tirofiban 50 microgram per 1 ml Aggrastat 12.5mg/250ml infusion bags | 1 bag P £160.72 (Hospital only) PIPERAZINE DERIVATIVES

PDF page 246

Dose text by age group

Adult

Initially 400 nanograms/kg/minute for

First-line fragment. Read the complete Indications and Dose section above.

PDF page 245

Adult

25 micrograms/kg, to be given over 3 minutes at

First-line fragment. Read the complete Indications and Dose section above.

PDF page 245

Adult

25 micrograms/kg, to be given over 3 minutes at

First-line fragment. Read the complete Indications and Dose section above.

PDF page 246

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.

Drug reference

Tirofiban

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 245, 246

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

PDF pages 245, 246

Contra Indications

PDF page 246

Cautions

PDF page 246

Safety

Interactions

→Appendix 1: tiroﬁban

PDF page 246

Side Effects

▶Common or very common Ecchymosis. fever. haemorrhage . headache. nausea. thrombocytopenia ▶Frequency not known Intracranial haemorrhage

PDF page 246

Pregnancy

Manufacturer advises use only if potential beneﬁt outweighs risk—no information available.

PDF page 246

Breast Feeding

Manufacturer advises avoid—no information available.

PDF page 246

Hepatic Impairment

Manufacturer advises caution in mild to moderate hepatic failure; avoid in severe hepatic failure (no information available).

PDF page 246

Renal Impairment

Increased risk of bleeding. Dose adjustments Use half normal dose if eGFR less than 30 mL/minute/1.73 m2. Monitoring Monitor carefully if eGFR less than 60 mL/minute/1.73 m2.

PDF page 246

Monitoring Requirements

Monitor platelet count, haemoglobin and haematocrit before treatment, 2–6 hours after start of treatment and then at least once daily.

PDF page 246

Dose and formulations

Directions For Administration

PDF page 246

Medicinal Forms

PDF page 246

Dose text by age group

Adult

Initially 400 nanograms/kg/minute for

First-line fragment. Read the complete Indications and Dose section above.

PDF page 245

Adult

25 micrograms/kg, to be given over 3 minutes at

First-line fragment. Read the complete Indications and Dose section above.

PDF page 245

Adult

25 micrograms/kg, to be given over 3 minutes at

First-line fragment. Read the complete Indications and Dose section above.

PDF page 246

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.