Tirofiban

How it works

It reversibly blocks the platelet glycoprotein IIb/IIIa receptor, preventing fibrinogen-mediated platelet aggregation, the final common step of thrombus formation.

Prescribing in practice

• Bleeding is the dominant risk — it is contraindicated in active bleeding, recent stroke, major surgery or trauma and other conditions predisposing to haemorrhage.
• Thrombocytopenia can occur, sometimes severely, so check platelet counts before and during therapy.
• Reduce the maintenance infusion rate in significant renal impairment as clearance is reduced.

Monitoring

Monitor for bleeding, full blood count including platelets, and renal function during the infusion.

Counselling the patient

• Explain this drip helps keep the blood from clotting in the heart's arteries.
• Report any unusual bruising, bleeding or blood in urine or stool.

Evidence & guidelines

Use in acute coronary syndromes and PCI is supported by randomised trials and reflected in cardiology guidelines.