Cardiovascular & blood

Eptifibatide

A cyclic peptide platelet blocker used during angioplasty and in acute coronary syndromes.

Strong evidenceApproved drugAdd to compare

What it is

Eptifibatide is a synthetic cyclic heptapeptide modelled on a disintegrin found in rattlesnake venom. It blocks the platelet glycoprotein IIb/IIIa receptor - the final common pathway of platelet aggregation - so platelets cannot bind fibrinogen and clump together. It is a hospital medicine given as a bolus and infusion during coronary procedures.

How it works

1
Binds the glycoprotein IIb/IIIa receptor on activated platelets.
2
Prevents fibrinogen and von Willebrand factor from cross-linking platelets.
3
Blocks platelet aggregation regardless of which pathway activated the platelet.
4
Reverses quickly after the infusion stops because it binds reversibly.
5
Its cyclic structure gives it high affinity and resistance to breakdown.

What it's studied for

Percutaneous coronary intervention

Non-ST-elevation acute coronary syndrome managed invasively

Adjunct to heparin during stenting in the glycoprotein-inhibitor era

Reported and studied effects

Reduced composite cardiac events at 30 days in the PURSUIT and ESPRIT trials
More major bleeding, particularly at access sites
Profound but reversible platelet inhibition
Thrombocytopenia in a small percentage of patients

Research protocol notes

Research context only

Research context only - a hospital drug. The PCI regimen is a 180 microgram per kilogram intravenous bolus followed by 2 micrograms per kilogram per minute, with a second bolus ten minutes later in the ESPRIT protocol and the infusion continued for 18 to 24 hours; platelet counts are checked during therapy.

These figures are described so you can understand what researchers did. They are not a dose, a schedule, or a suggestion — and they are not a substitute for a doctor.

Possible side effects and contraindications

Safety profile

Possible side effects

Major and minor bleeding
Thrombocytopenia
Hypotension
Nausea
Access-site complications
Rare hypersensitivity

Contraindications and cautions

Active bleeding or a bleeding disorder
History of stroke within 30 days or any haemorrhagic stroke
Severe hypertension
Dialysis dependence
Recent major surgery or thrombocytopenia

A side-effect list is never complete, and these are not the only situations that warrant caution. Anything unexpected, or anything you are unsure about, should be discussed with a doctor before use.

Evidence assessment

Strong evidenceReplicated, large human trials

Replicated, large human trials

Large randomised trials in acute coronary syndrome and PCI (PURSUIT, ESPRIT) with 30-day composite endpoints, and regulatory approval in the EU and US.

References

References link to published literature, regulator pages or literature indexes. Where a link points to a search, it collects the peer-reviewed work on that molecule rather than a single study.

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