Glycoprotein IIb IIIa Inhibitors
Glycoprotein IIb/IIIa inhibitors are medicines used in treating patients who have unstable angina, certain types of heart attacks, and in combination with angioplasty with or without stent placement. The drugs are given in combination with heparin or aspirin (blood-thinning agents) to prevent clotting before and during invasive heart procedures.
Glycoprotein IIb/IIIa inhibitors are classified as potent platelet inhibitors. These agents are used to prevent platelets from binding together, which can occur in patients with heart attacks and after angioplasty with or without stent placement.
The following list identifies specific glycoprotein IIb/IIIa inhibitors and their brand names:
- Abciximab (ReoPro®)
- Eptifibatide (Integrilin®)
- Tirofiban (Aggrastat®)
How are glycoprotein IIb/IIIa inhibitors given?
Glycoprotein IIb/IIIa inhibitors are administered only under the supervision of a doctor, through an intravenous injection or IV infusion during hospitalization.
Who is eligible to receive this medicine?
Patients with an acute coronary syndrome, such as unstable angina or certain kinds of heart attacks, are eligible to receive one of these agents. Other eligible patients include those undergoing coronary angioplasty with or without stent placement.
Patients who do not have low platelet counts and who are not at high risk for severe bleeding might be good candidates for the glycoprotein inhibitors. Patients with active internal bleeding should not take glycoprotein IIb/IIIa inhibitors. Inform your doctor of any health-related problems which could increase bleeding risk, such as recent surgery or severe injury, very high blood pressure, history of stroke, cancer, liver, or kidney disease (with or without dialysis). Tell your doctor if you are pregnant, plan on getting pregnant, or are breastfeeding
Your doctor will consider how this medicine will likely affect you before prescribing it. Inform your doctor of any known drug allergies. It is important to provide a complete list of all your prescription and over-the-counter medications, as well as any herbal or dietary supplements that you may be taking. Make sure your doctor knows if you are using any medication which could affect bleeding including aspirin, clopidogrel (Plavix®), dipyridamole (Persantine®), ticlopidine (Ticlid®), blood thinners such as warfarin (Coumadin®), dabigatran (Pradaxa®), rivaroxaban (Xarelto®), and pain or arthritis medications such as ibuprofen (e.g., Motrin®, Advil®), naproxen (e.g., Aleve®), or celecoxib (Celebrex®).
What are the side effects?
As with any medicine, an allergic reaction might occur. Additionally, glycoprotein IIb/IIIa inhibitors could cause headache, back pain, nausea/vomiting, dizziness/lightheadness/ fainting, and pain at the injection site. Their most common side effect is bleeding. Before, during, and after this medicine is taken, patients should have blood tests that indicate platelet count and clotting time of the blood.
Clotting tests might include
- Prothrombin time (PT)
- International normalization ratio (INR)
- Activated clotting time (ACT)
- Activated partial thromboplastin time (APTT)
Bleeding due to this medicine can occur anywhere in the body, but more commonly occurs around the injection site, mucous membranes (e.g., nose), the urinary tract, and the stomach. To reduce the risk of bleeding, use an electric razor and a soft toothbrush, and be careful when handling sharp objects. Tell your physician if you experience unusual bruising or bleeding (e.g., blood in urine or stool), dizziness, vision changes, or back pain. In rare cases, patients might require blood transfusions if they develop an unusually low amount of red blood cells.
This medicine is given in the hospital, and patients are closely monitored so that any possible side effects might be treated promptly.
- Quinn MJ, Plow EF, Topol EJ. Platelet glycoprotein IIb/IIIa inhibitors: recognition of a two-edged sword? Circulation.2002;106(3):379-385
- Angiolillo DJ, Giugliano GR, Simon D . Chapter 61. Pharmacologic Therapy for Acute Coronary Syndromes. In: Fuster V, Walsh RA, Harrington RA, eds. Hurst's The Heart. 13th ed. New York: McGraw-Hill; 2011. www.accessmedicine.com. Accessed 1/4/2013
- Drugs.com. Drug Information Database: Glycoprotein Platelet Inhibitors www.drugs.com. Accessed 1/4/2013
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 5/23/2012...#9966