Tirofiban is a medication that belongs to the class of glycoprotein IIb/IIIa inhibitors.
Trade name, Agrastat.
It prevents platelets from aggregating by blocking the glycoprotein IIb/IIIa receptor on platelet surfaces, which is the final common pathway for platelet aggregation.
Works by reversibly blocking the GP IIb/IIIa receptors on the surface of platelets, preventing them from clumping together to form dangerous clots.
It acts quickly, often achieving greater than 90% platelet inhibition within 30 minutes of starting an intravenous infusion.
This medication is given exclusively via a continuous intravenous (IV) drip under direct medical supervision.
It is mainly used in the hospital setting for patients with acute coronary syndromes (ACS), such as unstable angina or non–ST-elevation myocardial infarction (NSTEMI), and sometimes during percutaneous coronary intervention, like angioplasty/stenting to reduce the risk of clot formation.
It is given intravenously, usually alongside heparin and aspirin.
The most common side effect is bleeding, especially at vascular access sites, and less commonly thrombocytopenia.
In patients with acute ischemic non-cardiac embolic stroke, who underwent thrombolysis within 4.5 hours after onset, early tirofiban increased the likelihood of excellent functional outcome.
Vascular occlusion may occur after intravenous thrombolysis and may be preventable by the addition of an anti-platelet agent within the first 24 hours after thrombolysis .
Tirofibran is a platelet glycoprotein IIb-IIIa receptor antagonist thar reduces macrovascular occlusion.
Among patients with acute ischemic stroke without large or medium vessel occlusions or a cardioembolic source who had an inadequate clinical response to intravenous tenecteplase, adjunctive intravenous tirofiban increased the likelihood of an excellent outcome at 90 days.
Standard Regimen: Typically starts with a loading dose of 25 mcg/kg given over five minutes, followed by a maintenance infusion of 0.15 mcg/kg/min for up to 18 hours.
For patients with reduced kidney function (creatinine clearance ≤ 60 mL/min), the maintenance dose is decreased to 0.075 mcg/kg/min to prevent bleeding complications.
Tirofiban strongly inhibits blood clotting, the most common complication is an increased risk of bleeding.
Among patients with acute ischemic stroke without large or medium vessel occlusions or a cardioembolic source who had an inadequate clinical response to intravenous tenecteplase, adjunctive intravenous tirofiban increased the likelihood of an excellent outcome at 90 days.
Contraindications: It should never be used in patients with active internal bleeding, a history of recent hemorrhagic stroke, severe uncontrolled high blood pressure, or known severe thrombocytopenia.
Side Effects: Besides bleeding, users may experience nausea, fever, headache, or an immune-mediated thrombocytopenia.