Integril
Generic Name
Eptifibatide
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| integril 2 mg injection | ৳ 3,000.00 | N/A |
| integril 075 mg injection | ৳ 9,000.00 | N/A |
Description
Overview of the medicine
Integril (Eptifibatide) is an antiplatelet medication used to prevent blood clots in individuals with acute coronary syndrome or undergoing percutaneous coronary intervention. It works by blocking the glycoprotein IIb/IIIa receptor on platelets, thereby inhibiting platelet aggregation.
Uses & Indications
Dosage
Adults
For ACS: 180 mcg/kg IV bolus followed by a continuous infusion of 2 mcg/kg/min for up to 72-96 hours. For PCI: 180 mcg/kg IV bolus, followed immediately by a continuous infusion of 2 mcg/kg/min, then a second 180 mcg/kg bolus 10 minutes after the first bolus. Infusion continues for 18-24 hours post-PCI.
Elderly
No specific dose adjustment required based solely on age, but renal function should be carefully monitored and dose adjusted if needed.
Renal_impairment
For moderate renal impairment (creatinine clearance ≥30 to <50 mL/min): 180 mcg/kg IV bolus, followed by a continuous infusion of 1 mcg/kg/min. Not recommended for severe renal impairment (creatinine clearance <30 mL/min) or end-stage renal disease requiring dialysis.
How to Take
Integril is administered as an intravenous bolus followed by a continuous intravenous infusion, typically in a hospital setting under close medical supervision.
Mechanism of Action
Eptifibatide is a reversible glycoprotein IIb/IIIa receptor antagonist. It binds to the platelet glycoprotein IIb/IIIa receptor, preventing the binding of fibrinogen, von Willebrand factor, and other adhesive ligands. This inhibits the final common pathway of platelet aggregation, thereby preventing the formation of blood clots.
Pharmacokinetics
Onset
Platelet inhibition occurs within minutes of intravenous administration.
Excretion
Approximately 50% of the administered dose is recovered in the urine as eptifibatide and its metabolites.
Half life
The elimination half-life is approximately 2.5 hours.
Absorption
Administered intravenously, resulting in 100% bioavailability.
Metabolism
Primarily cleared by renal excretion, with limited hepatic metabolism (deacetylation).
Side Effects
Contraindications
- Active pathological bleeding or a history of bleeding diathesis within the preceding 30 days.
- History of stroke within 30 days or any hemorrhagic stroke.
- Major surgery within the preceding 6 weeks.
- Severe uncontrolled hypertension (systolic blood pressure >200 mm Hg or diastolic blood pressure >110 mm Hg) refractory to antihypertensive therapy.
- History of thrombocytopenia following previous administration of a glycoprotein IIb/IIIa inhibitor.
- Dependence on renal dialysis.
Drug Interactions
NSAIDs
May increase the risk of gastrointestinal bleeding.
Anticoagulants (e.g., heparin, warfarin)
Increased risk of bleeding.
Other antiplatelets (e.g., aspirin, clopidogrel, prasugrel, ticagrelor)
Potentiates antiplatelet effect, leading to increased bleeding risk.
Storage
Store refrigerated at 2°C to 8°C (36°F to 46°F). Protect from light. Do not freeze. Discard any unused portion.
Overdose
Overdose of Integril can lead to increased bleeding complications. Management involves discontinuing Integril and other antithrombotic agents, careful monitoring, and supportive therapy, which may include transfusion of blood products (e.g., platelets) if severe bleeding occurs.
Pregnancy & Lactation
Pregnancy Category B. Studies in animals have shown no evidence of fetal harm, but there are no adequate and well-controlled studies in pregnant women. Use only if clearly needed. It is not known whether eptifibatide is excreted in human milk; caution should be exercised when administered to a nursing mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from manufacturing date when stored correctly.
Availability
Available in hospitals and pharmacies
Approval Status
Approved by FDA and DGDA
Patent Status
Off-patent for generic Eptifibatide; Integril brand patent status varies
Clinical Trials
Integril (Eptifibatide) has been extensively studied in large-scale clinical trials (e.g., PURSUIT, ESPRIT) demonstrating its efficacy and safety in reducing ischemic events in patients with ACS and those undergoing PCI.
Lab Monitoring
- Platelet count (before treatment, within 6 hours of start, and daily thereafter)
- Activated partial thromboplastin time (aPTT)
- Prothrombin time (PT) / International Normalized Ratio (INR)
- Serum creatinine (renal function)
Doctor Notes
- Careful patient selection is crucial due to bleeding risk.
- Close monitoring of platelet count, renal function, and bleeding parameters is essential.
- Ensure proper concomitant medication management, especially antiplatelets and anticoagulants.
Patient Guidelines
- Report any signs of unusual bleeding or bruising immediately to your healthcare provider.
- Remain in bed rest as advised by your doctor during and after administration.
- Do not take any other medications, especially over-the-counter pain relievers or blood thinners, without consulting your doctor.
Missed Dose Advice
As Integril is administered in a controlled hospital environment, missed doses are unlikely. If an administration issue occurs, the medical team should be notified immediately.
Driving Precautions
Integril is typically administered in a hospital setting. Patients should not drive or operate machinery during treatment or until advised by their doctor, as the underlying condition and potential side effects (e.g., hypotension) may impair abilities.
Lifestyle Advice
- Avoid activities that may increase the risk of bleeding or bruising, such as contact sports or vigorous activities, while on Integril.
- Maintain good oral hygiene to prevent gum bleeding.
- Report any falls or injuries, even minor ones, to your medical team.
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