Tirofiban (GPIIb/IIIa Inhibitor — ACS/PCI)

How it works

It reversibly blocks the platelet glycoprotein IIb/IIIa receptor, preventing fibrinogen binding and thereby inhibiting the final common pathway of platelet aggregation.

Prescribing in practice

• Bleeding is the principal risk, and it is contraindicated in active bleeding or recent major haemorrhage, including intracranial bleeding, and used with other anticoagulant and antiplatelet therapy under careful monitoring.
• The dose must be reduced in significant renal impairment as clearance is renal.
• Thrombocytopenia can occur and platelet count should be checked.

Monitoring

Monitor for bleeding, platelet count and haemoglobin during and after infusion, with attention to renal function.

Counselling the patient

• Report any bleeding, bruising or blood in urine or stools.
• This medicine is given in hospital alongside other blood-thinning treatment.
• Tell staff about any recent surgery, injury or bleeding problems.

Evidence & guidelines

Tirofiban is supported by acute coronary syndrome and PCI trial evidence and is used as a glycoprotein IIb/IIIa inhibitor within current guidance.