Eptifibatide use in specific populations
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sheng Shi, M.D. [2]
Use In Specific Populations
Pregnancy
Pregnancy Category B
Teratology studies have been performed by continuous intravenous infusion of eptifibatide in pregnant rats at total daily doses of up to 72 mg/kg/day (about 4 times the recommended maximum daily human dose on a body surface area basis) and in pregnant rabbits at total daily doses of up to 36 mg/kg/day (also about 4 times the recommended maximum daily human dose on a body surface area basis). These studies revealed no evidence of harm to the fetus due to eptifibatide. There are, however, no adequate and well-controlled studies in pregnant women with INTEGRILIN. Because animal reproduction studies are not always predictive of human response, INTEGRILIN should be used during pregnancy only if clearly needed.
Nursing Mothers
It is not known whether eptifibatide is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when INTEGRILIN is administered to a nursing mother.
Pediatric Use
Safety and effectiveness of INTEGRILIN in pediatric patients have not been studied.
Geriatric Use
The PURSUIT and IMPACT II clinical studies enrolled patients up to the age of 94 years (45% were age 65 and over; 12% were age 75 and older). There was no apparent difference in efficacy between older and younger patients treated with INTEGRILIN. The incidence of bleeding complications was higher in the elderly in both placebo and INTEGRILIN groups, and the incremental risk of INTEGRILIN-associated bleeding was greater in the older patients. No dose adjustment was made for elderly patients, but patients over 75 years of age had to weigh at least 50 kg to be enrolled in the PURSUIT study; no such limitation was stipulated in the ESPRIT study[see Adverse Reactions (6.1)].
Renal Impairment
Approximately 50% of eptifibatide is cleared by the kidney in patients with normal renal function. Total drug clearance is decreased by approximately 50% and steady-state plasma INTEGRILIN concentrations are doubled in patients with an estimated CrCl <50 mL/min (using the Cockcroft-Gault equation). Therefore, the infusion dose should be reduced to 1 mcg/kg/min in such patients [see Dosage and Administration (2)]. The safety and efficacy of INTEGRILIN in patients dependent on dialysis has not been established.[1]
References
- ↑ "INTEGRILIN (EPTIFIBATIDE) INJECTION, SOLUTION [MERCK SHARP & DOHME CORP.]". Retrieved 5 February 2014.