TIROFIBAN

Tirofiban is a rapid-acting antiplatelet medication administered in hospital settings to reduce the risk of thrombotic events during acute coronary syndromes or specific coronary interventional procedures. It functions as a glycoprotein IIb/IIIa receptor antagonist, a drug class that inhibits the final pathway of platelet aggregation leading to clot formation. The drug received its initial regulatory approval in 1998 in the United States. Subsequent approvals followed in other regions according to regional acute cardiac care protocols, primarily for patients with non-ST-elevation acute coronary syndrome and selected percutaneous coronary interventions in adult populations.

Tirofiban uses are: Preventing blood clots in patients with unstable angina Reducing the risk of non-ST-elevation myocardial infarction (NSTEMI) Supporting percutaneous coronary intervention (PCI) to prevent platelet aggregation Managing acute coronary syndromes in high-risk patients

Tirofiban is administered through the intravenous route only. It is a hospital-use drug that requires controlled delivery using infusion equipment. A commonly used method is a two-step process. The first step is a bolus dose delivered into the vein over a few minutes, followed immediately by a continuous infusion for several hours. The infusion rate is adjusted based on the patient's kidney function, since renal clearance plays a significant role in elimination. Treatment typically runs for less than 24 hours and is always managed by trained healthcare teams in monitored settings.

Common Tirofiban side effects: Bleeding at injection site Nosebleeds Headache Dizziness Serious or rare side effects: Severe internal bleeding Low platelet count (thrombocytopenia) Allergic reactions Hypotension Seek immediate medical attention if you experience excessive bleeding, severe dizziness, or signs of an allergic reaction.

Higher chance of serious bleeding, including internal bleeding or bleeding from vascular access points. Sudden severe reduction in platelet count can appear early after exposure in some patients. Serious allergic reactions, including life threatening immune responses, are possible in first or repeat exposure. Bleeding risk rises markedly when used with anticoagulants, thrombolytics, or other antiplatelet medicines and must be assessed carefully.

Avoid use in patients with: Active internal bleeding. Recent major surgery or severe physical trauma. Documented intracranial bleeding history or vascular malformations, unless the clinical benefit is clearly justified. Measure kidney function before therapy to decide safe infusion rates. Check haemoglobin, hematocrit, and platelet levels at baseline and repeat during infusion. Observe continuously for: Bruising, blood in urine or stools, unexplained weakness, or neurological changes. Not approved for children, limited evidence outside adult acute cardiology. In pregnancy or breastfeeding, consider only when absolutely required with strict clinician oversight.

https://go.drugbank.com/drugs/DB00775 McClellan KJ, Goa KL. Tirofiban. A review of its use in acute coronary syndromes. Drugs. 1998 Dec;56(6):1067-80. doi: 10.2165/00003495-199856060-00017. PMID: 9878994. https://www.sciencedirect.com/topics/medicine-and-dentistry/tirofiban