Eptifibatide

Integrilin is eptifibatide, a cyclic seven-amino-acid antiplatelet drug inspired by an anti-aggregation protein in pygmy-rattlesnake venom. It was approved in the United States in 1998 and is used in hospitals for acute coronary events and coronary intervention.

Supporting references: pygmy rattlesnake.

Eptifibatide reversibly occupies platelet glycoprotein IIb/IIIa, preventing fibrinogen from linking activated platelets together. This blocks the final common aggregation step and is rapidly reversible when infusion stops. It is useful when disrupted coronary plaque or a new stent creates acute clot risk. PURSUIT found a lower combined 30-day rate of death or nonfatal myocardial infarction in acute coronary syndrome, at the cost of more bleeding. Renal clearance makes kidney function important to dose reduction.

Supporting references: reduced.

The 1998 FDA approval covers acute coronary syndrome, including medical management and percutaneous coronary intervention. Hospital teams use an IV bolus followed by infusion alongside other antithrombotic therapy for unstable angina/non-ST-elevation infarction or PCI to reduce clot-related complications.

Supporting references: approved.

Common effects include vascular-access-site bleeding and hypotension. Major hemorrhage is the principal serious risk, and thrombocytopenia can occur. Listed contraindications include active or recent serious bleeding, severe uncontrolled hypertension and dialysis-dependent renal failure, among other product-specific restrictions.