Eptifibatid

Eptifibatide, commonly spelled eptifibatide, is a synthetic cyclic heptapeptide that acts as a glycoprotein IIb/IIIa receptor antagonist. By reversibly binding to the GP IIb/IIIa receptor on activated platelets, it prevents fibrinogen and von Willebrand factor from cross-linking platelets, thereby reducing platelet aggregation. It is marketed under the brand name Integrilin and is used as an antiplatelet agent in acute coronary syndrome and during percutaneous coronary intervention.

It is administered by intravenous infusion and provides rapid onset of action, with effects diminishing after the infusion is stopped. The drug is primarily excreted by the kidneys, so dosing and duration may be adjusted in patients with renal impairment. In clinical practice, eptifibatide is commonly used in combination with aspirin and anticoagulants such as heparin as part of ACS management and PCI protocols. The regimen typically includes an initial bolus dose followed by a continuous infusion for up to 24 hours, with adjustments based on renal function and clinical scenario.

Bleeding is the principal safety concern and the most common adverse effect. Other risks include thrombocytopenia, hypotension, and, less commonly, allergic reactions. Eptifibatide is contraindicated in patients with active major bleeding, a history of certain intracranial hemorrhages, recent major surgery or trauma, severe uncontrolled hypertension, or known hypersensitivity to the drug. Caution is advised in elderly patients and those with severe renal impairment, as well as in settings where invasive procedures with bleeding risk are anticipated.

History and regulation: eptifibatide was developed for antiplatelet therapy in ACS and PCI and received regulatory approval in the late 1990s. It remains a commonly used GP IIb/IIIa inhibitor in contemporary interventional cardiology, though its use varies with evolving treatment guidelines and alternative antiplatelet strategies.