Abciximab

Intravenous
Unstable angina

Intravenous
Adjunct in the prophylaxis of acute ischaemic complications in percutaneous coronary intervention

Severe (requiring haemodialysis): Contraindicated.

Severe: Contraindicated.

IV infusion: Withdraw the required amount of drug into a syringe using 0.2 micron or 5 micron low protein-binding syringe filter (or equivalent) then inject into 250 mL of NaCl 0.9% or dextrose 5% in water to make a soln.

Active internal bleeding or recent (w/in 6 wk) clinically-significant GI or genitourinary bleeding; history of CVA w/in 2 yr or CVA w/ significant residual neurological deficit; clotting abnormalities; recent (w/in 2 mth) intracranial or intraspinal surgery or trauma; recent (w/in 2 mth) major surgery; intracranial neoplasm, arteriovenous malformation or aneurysm; known bleeding diathesis or severe uncontrolled HTN; pre-existing thrombocytopenia; vasculitis; hypertensive retinopathy. Severe renal impairment requiring haemodialysis and severe hepatic impairment. Concomitant use of oral anticoagulants w/in 7 days (unless prothrombin time (PT) is ≤1.2 times the control PT value). IV admin of dextran before PCI or intent to use it during an intervention.

Patient w/ haemorrhagic retinopathy, acute pericarditis, aortic dissection. Severe renal impairment. Pregnancy and lactation.

Hypotension, nausea and vomiting, back pain, chest pain, headache, haematoma, bradycardia, fever, cardiac tamponade, thrombocytopenia.
Potentially Fatal: Bleeding (during the 1st 36 hr of admin); anaphylactic reactions.

Monitor platelet count at baseline, 2-4 hr after bolus infusion, and at 24 hr; prothrombin time, aPTT, Hb, haematocrit, fibrinogen, fibrin split products, transfusion requirements, signs of hypersensitivity reactions, guaiac stools, Hemastix^® urine.

Increased risk of bleeding w/ other antiplatelet drugs or thrombolytics.
Potentially Fatal: Major bleeding episodes may occur w/ concomitant oral anticoagulants or IV admin of dextran.

Description:
Mechanism of Action: Abciximab is the Fab fragment of the chimeric monoclonal antibody 7E3 which binds to glycoprotein (GP) IIb or IIIa receptor on platelet surface, thus preventing binding of fibrinogen, von Willebrand factor, and other adhesive molecules to the receptor sites, leading to inhibition of platelet aggregation.
Onset: Rapid; platelet aggregation reduced to <20% of baseline at 10 min.
Duration: Up to 72 hr for restoration of normal haemostasis.
Pharmacokinetics:
Absorption: Time to peak plasma concentration: Approx 30 min (platelet inhibition).
Distribution: Volume of distribution: 0.07 L/kg. Plasma protein binding: Mostly bound to GP IIb/IIIa receptors on platelet surface.
Metabolism: Unbound drug is metabolised via proteolytic cleavage.
Excretion: Plasma elimination half-life: Approx 30 min.

Store between 2-8°C. Do not freeze or shake.

Anticoagulants, Antiplatelets & Fibrinolytics (Thrombolytics)

B01AC13 - abciximab ; Belongs to the class of platelet aggregation inhibitors excluding heparin. Used in the treatment of thrombosis.

Anon. Abciximab. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 04/11/2015.

Buckingham R (ed). Abciximab. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 04/11/2015.

McEvoy GK, Snow EK, Miller J et al (eds). Abciximab. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). www.medicinescomplete.com. Accessed 04/11/2015.

Reopro Injection, Solution (Eli Lilly and Company). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 04/11/2015.