Abciximab

Administration

• Type: Glycoprotein IIB/IIIA inhibitor, antiplatelet
• Dosage Forms: Injection
• Routes of Administration: IV
• Common Trade Names: Reopro

Adult Dosing

PCI Adjunct

• 0.125 mcg/kg/min IV x 12h
  • Part of multidrug regiment with heparin and aspirin

Unstable angina, refractory

• 10 mcg/min IV x 18-24h
  • Part of multidrug regiment with heparin and aspirin

Pediatric Dosing

Safety/efficacy not established in pediatric patients

Special Populations

Pregnancy Rating

• Benefits outweigh risks during pregnancy
• Inadequate human data available to assess risk
• Risk of maternal hemorrhage during delivery

Lactation risk

• May use while breast feeding

Renal Dosing

• Adult: Not defined
• Pediatric: Unavailable

Hepatic Dosing

• Adult: Not defined
• Pediatric: Unavailable

Contraindications

• Allergy to class/drug
• Hypersensitivity to murine proteins
• Active internal bleeding
• GI/GU bleeding w/in 6 weeks
• Stroke w/in 2 years
• Coagulation disorder
• Plt < 100,000
• INR > 1.2
• Recent surgery or trauma
• HTN, uncontrolled
• Intracranial neoplasm, AVM, or aneurysm
• Vasculitis hx
• Dextran use in coronary procedure

Adverse Reactions

Serious

• Thrombocytopenia
• Bleeding
• AV Block, complete
• Anaphylaxis

Common

• Bleeding, hypotension
• Back pain, chest pain, abdominal pain
• Peripheral edema
• Nausea, vomiting
• Headache, dizziness
• Bradycardia

Pharmacology

• Half-life: <10 min initially then 30 min second phase
• Metabolism: Other
• Excretion: Urine

Mechanism of Action

• Binds to platelet glycoprotein IIb/IIIa receptors, reducing platelet aggregation

See Also

• Antiplatelet medications
• Antiplatelet agent reversal

References

• Aguirre FV, Topol EJ, and Ferguson JJ, “Bleeding Complications With the Chimeric Antibody to Platelet Glycoprotein IIb/IIIa Intergrin in Patients Undergoing Percutaneous Coronary Intervention. EPIC Investigators,” Circulation, 1995, 91(12):2882-90. [PubMed 7796496]
• Amsterdam EA, Wenger NK, Brindis RG, et al; American College of Cardiology; American Heart Association Task Force on Practice Guidelines; Society for Cardiovascular Angiography and Interventions; Society of Thoracic Surgeons; American Association for Clinical Chemistry. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines [published correction appears in J Am Coll Cardiol. 2014;64(24):2713-2714]. J Am Coll Cardiol. 2014;64(24):e139-e228. doi: 10.1016/j.jacc.2014.09.017. [PubMed 25260718
• Antman EM, Giugliano RP, Gibson CM, et al, “Abciximab Facilitates the Rate and Extent of Thrombolysis: Results of the Thrombolysis in Myocardial Infarction (TIMI) 14 Trial. The TIMI 14 Investigators,” Circulation, 1999, 99(21):2720-32. [PubMed 10351964]
• “ASSENT-3 Investigators. Efficacy and Safety of Tenecteplase in Combination With Enoxaparin, Abciximab, or Unfractionated Heparin: The ASSENT-3 Randomised Trial in Acute Myocardial Infarction,” Lancet, 2001, 358 (9282):605-13. [PubMed 11530146]