REOPRO
ABCIXIMAB · by ELI LILLY
Composition
Inj: Per ml: Abciximab 2 mg; 5 ml soln.
Indications & Dosage
Prevention of ischaemic cardiac complications in patients undergoing percutaneous coronary intervention: BY IV INJ OR INF: Adults: 0.25 mg/ kg by bolus IV inj. 10-60 min prior to PTCA and immediately followed by a 0.125 mcg/kg/min. continuous IV INF for 12 hr. Short-term prevention of myocardial infarction in patients with unstable angina not responding to conventional treatment and who are scheduled for percutaneous coronary intervention: BY IV INJ OR INF: Adults: 0.25 mg/kg by bolus IV inj up to 24 hr prior to PTCA and immediately followed by a 0.125 mcg/kg/min. continuous IV INF for 12 hr after the intervention. Elderly: Over 80 yr, not recommended. Children: Not recommended.
Administration
For intravenous infusion: Give continuously in Glucose 5% or Sodium Chloride 0.9%. Dilute requisite dose in infusion fluid andgive via infusion pump; filter upon dilution through a non pyrogenic low protein binding 0.2, 0.22, or 5 micron filteror upon administration through an in-line non-progeniclow protein-binding 0.2 or 0.22 micron filter. Administer oral aspirin at a dose of not less than 300 mg daily. Administer Heparin in a low-dose weight adjusted regimen: see literature.
Contraindications
Active internal bleeding, arteriovenous malformation or aneurysm, haemorrhagic diathesis, hypertensive retinopathy, intracranial neoplasm, intracranial or intraspinal surgery or trauma within last 2 months, major surgery within last 2 months, severe hypertension, stroke within last 2 years, thrombocytopenia, vasculitis.
Precautions
Hepatic impairment; avoid in severe liver disease increased risk of bleeding. Renal impairment; caution in severe impairment increased risk of bleeding, peripheral vascular disease, risk of anaphylaxis. Measure baseline prothrombin time, activated clotting time, activated partial thromboplastin time, platelet count, haemoglobin and haematocrit. Monitor haemoglobin and haematocrit 12 hours and24 hours after start of treatment and platelet count2-4 hours and 24 hours after start of treatment,transfuse platelets if count drops below 50,000 cells/microliters. Cardio-pulmonary resuscitation facilities must be available. Pretreat with an H2 antagonist to prevent gastro-intestinal bleeding.
Interactions
Caution with concomitant use of drugsthat increase risk of bleeding. Additive effects with thrombolytics, anticoagulants, anti platelet agents
Pregnancy
Risk cannot be ruled out, use only if potential benefit outweighs risk
Lactation
Caution advised or effect undetermined.
Side Effects
Bleeding, chest pain, bradycardia, fever, headache, hypotension, nausea, back pain, thrombocytopenia, vomiting. Rare: Adult respiratory distress, cardiac tamponade, hypersensitivity reactions.