Integrilin

Integrilin is a drug used to treat various diseases affecting the cardiovascular system. It is prescribed to prevent myocardial infarction, as well as to prevent vascular closure and subsequent ischemic complications.

The medicinal substance is an antiplatelet drug. The medicinal effect it has is based on the activity of the active element of the drug - the component eptifibatide.

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Indications Integrilina

It is used in cases of coronary syndrome in the active phase (this includes unstable angina and acute myocardial infarction). In addition, it can be prescribed to prevent occlusion of the affected artery by thrombi, as well as ischemic complications that occur in connection with the implementation of PTCA.

The medication can be used in combination with aspirin, as well as unfractionated heparin.

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Release form

The drug is produced in the form of a liquid for intravenous injections. It is contained in 100 ml vials. Inside the package there is also a device with which the vial with the medicine is suspended.

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Pharmacodynamics

The slowdown in platelet aggregation is reversible – platelet activity is restored by half after 4 hours from the infusion. The drug has no noticeable effect on the level of PT or APTT.

Integrilin inhibits platelet aggregation during intravenous administration. The intensity of this inhibition depends on the size of the dose administered and the drug parameters.

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Dosing and administration

Integrilin can be prescribed only to adult patients.

People who have no contraindications to the use of heparin can use it in combination with the drug.

In addition, the drug is used together with aspirin, because it is an obligatory component of therapy for coronary syndrome in the active phase. Aspirin cannot be used only by those people for whom it is contraindicated.

In acute coronary syndrome, the medication is administered by intravenous jet in a dose of 180 mcg/kg. Then it is necessary to transfer to administration through a dropper in a dosage of 1-2 mcg/kg per minute (depending on serum creatinine values) within 3 days (or until the end of inpatient therapy).

In case of urgent need for PTCA, the infusion should be continued for 18 or 24 hours from the moment of the procedure (treatment should last a maximum of 96 hours). Persons weighing more than 121 kg are prohibited from administering more than 22.6 mg (bolus), as well as 15 or 7.5 mg/hour (infusion). Accordingly, the creatinine values are below 0.18, as well as 0.18-0.36 mmol/l.

Before performing PTCA, it is necessary to administer a bolus of 180 mcg/kg of the substance, and then administer another 1-2 mcg/kg of the drug per minute via continuous infusion (depending on the creatinine level).

After 10 minutes from the moment of the first bolus, another 180 mcg/kg of the drug is administered in the same way. This infusion should last 18-24 hours or until the end of hospitalization. The minimum duration of the procedure is 12 hours.

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Use Integrilina during pregnancy

The decision regarding the use of drugs during pregnancy can only be made by a doctor, taking into account all the risks and benefits of such use for the woman and the fetus.

There is no information on whether eptifibatide is excreted in breast milk. Therefore, breastfeeding should be discontinued during therapy.

Contraindications

Main contraindications:

• bleeding in the gastrointestinal tract or of a genital or urological nature, as well as other intense bleeding of a pathological nature observed in the patient during the last month;
• thrombocytopenia;
• severe intolerance caused by the action of the active element or other components of the drug;
• previous intracranial pathology (tumor, aneurysm, or arteriovenous malformation);
• a history of hemorrhagic stroke or acute cerebrovascular accident within the last month;
• the PTV index is higher than 1.2 of the control level or INR≥2;
• previously suffered diathesis of hemorrhagic nature;
• clinically significant liver failure;
• severe trauma or major surgery that occurred within the last 1.5 months;
• a strong increase in blood pressure values during antihypertensive therapy;
• severe renal failure;
• planned introduction of another similar drug or combined administration with it;
• the need for hemodialysis sessions.

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Side effects Integrilina

Side effects include:

• Blood and lymph related disorders: bleeding (both mild and heavy) often occurs in the area behind the peritoneum, in the mouth or oropharynx, in the gastrointestinal tract, inside the skull or urogenital, as well as hematuria). Thrombocytopenia sometimes develops;
• lesions affecting the heart: often observed are CHF, ventricular tachycardia, ventricular fibrillation, cardiac arrest, AV block and atrial fibrillation;
• disorders in the functioning of the nervous system: sometimes cerebral ischemia occurs;
• problems with vascular function: decreased blood pressure, phlebitis or cardiogenic shock.

Information obtained from post-registration studies:

• lymph and blood lesions: hematomas, various types of bleeding in the lungs, deep thrombocytopenia in the active phase and bleeding with a fatal outcome appear sporadically;
• infection of the subcutaneous layers and epidermis: rashes and negative signs in the injection area (urticaria) develop occasionally;
• immune disorders: anaphylactic reactions occur occasionally.

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Overdose

There is limited information regarding Integrilin toxicity. It is suggested that bleeding may occur when high doses of the drug are administered.

The effect of the drug can be reduced by stopping the infusion. In addition, the drug is excreted through hemodialysis. Sometimes the patient may need a blood transfusion.

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Interactions with other drugs

It is prohibited to combine Integrilin and furosemide.

The medication should be used with caution together with drugs that affect hemostasis: these include adenosine, NSAIDs, dextran, drugs containing prostacyclin, and also oral anticoagulants and thrombolytics.

Combining drugs with streptokinase (administered during treatment of the acute stage of myocardial infarction) increases the likelihood of bleeding.

The simultaneous use of the drug with heparin is permitted only in the absence of any contraindications to the administration of the latter (for example, a history of thrombocytopenia that developed due to the use of heparin).

The drug should be combined with low molecular weight heparin with extreme caution.

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Storage conditions

Integrilin should be stored in a dark place, out of the reach of small children. Temperature indicators are in the range of 2-8°C.

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Shelf life

Integrilin can be used for a period of 36 months from the date of manufacture of the drug.

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Application for children

Intergrilin is prohibited for use in pediatrics.

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Analogues

An analogue of the drug is Eptifibatide.

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Reviews

Integrilin receives good reviews from patients and doctors. Doctors indicate that the drug works well in the treatment or prevention of certain diseases affecting the cardiovascular system. Patients highlight the high speed of drug action and its effectiveness.

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