tirofiban

Tirofiban is a nonpeptide antagonist of the platelet glycoprotein IIb/IIIa receptor, used as an antiplatelet agent in the management of acute coronary syndromes and during percutaneous coronary intervention. By blocking the GP IIb/IIIa receptor, tirofiban prevents fibrinogen-mediated cross-linking of platelets and thus inhibits platelet aggregation, providing rapid but short-lived antithrombotic effects.

Tirofiban is administered intravenously as a weight-based regimen that typically includes an initial bolus followed by a continuous infusion. It has a rapid onset of action and a relatively short half-life, approximately 2 hours, with most of the antiplatelet effect diminishing within hours after stopping the infusion. The drug is predominantly cleared by the kidneys, so dosing and duration are adjusted in patients with renal impairment. Treatment regimens vary by indication and protocol, and infusions are generally continued for a defined period around PCI or for a limited duration in acute coronary syndromes.

Clinical use centers on reducing ischemic complications in patients with acute coronary syndromes undergoing PCI or in high-risk ACS patients when used with other antithrombotic agents such as heparin. Because of its mechanism, tirofiban increases the risk of bleeding, including major or intracranial bleeding, and thrombocytopenia can occur rarely. It is contraindicated in patients with active major bleeding, severe bleeding diatheses, recent intracranial hemorrhage, significant uncontrolled hypertension, recent major surgery or trauma, or severe renal failure requiring dialysis, among other cautions.

Brand name and regulatory status: tirofiban is marketed under the brand name Aggrastat in many regions and is approved for use as an adjunct to PCI and in selected ACS settings, with recommended monitoring for bleeding and platelet counts.