Dosing and uses of ReoPro (abciximab)
Adult dosage forms and strengths
injectable solution
- 2mg/mL
Adjunct to PCI
Prevention of cardiac ischemic complications in patients undergoing PCI
0.25 mg/kg IV bolus over at least 1 min, 10-60 min before start of PCI, THEn
0.125 mcg/kg/min IV continuous infusion for 12 hr; not to exceed infusion rate of 10 mcg/min
Unstable Angina
Indicated for prevention of cardiac complications in patients with unstable angina with PCI planned within 24 hr
0.25 mg/kg IV bolus over at least 1 minute, THEn
0.125 mcg/kg/min IV continiuous infusion for 18-24 hr concluding 1 hour post-PCI; not to exceed 10 mcg/min
Stop continuous infusion of abciximab in patients with failed PCIs
Other Indications & Uses
Adjunctive therapy during thrombolysis (off-label)
Pediatric dosage forms and strengths
Safety and efficacy not established
ReoPro (abciximab) adverse (side) effects
>10%
Bleeding, minor (70-82%)
Bleeding, major (17-21%)
Hypotension (14-21%)
Back pain (17.6%)
Nausea (13.6%)
Chest pain (11.4%)
Vomiting (7-11%)
1-10%
Headache (6%)
Thrombocytopenia (2-6%)
Bradycardia (5%)
Injection site pain (3.6%)
Extremity pain (3.5%)
Abdominal pain (3%)
UTI (2%)
Dizziness (1.8%)
Peripheral edema (1.6%)
Anemia (1.2%)
Diarrhea (1%)
Hypoesthesia (1%)
Warnings
Contraindications
Hypersensitivity
Active major bleeding, thrombocytopenia, history of CVA (within 2 years)
Peptic ulcer disease
Recent surgery of trauma, intracranial neoplasm, uncontrolled HTN, vasculitis
Oral anticoagulant use within 7 days increases bleeding risk
Cautions
Intended for use with aspirin and heparin, and has only been studied in that setting
Increased bleeding risk when used with thrombolytic agents
Monitor for thrombocytopenia
Pregnancy and lactation
Pregnancy category: C
Lactation: not known if excreted in breast milk; use caution
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of ReoPro (abciximab)
Mechanism of action
Chimeric monoclonal antibody; prevents binding of fibrinogen, vWF to glycoprotein IIb/IIIa receptor sites on platelets
Pharmacokinetics
Half-life: 30 min
Onset: 10 min (<20% of baseline)
Duration: 72 hr
Metabolism: Through proteolytic cleavage
Platelet binding: Remains bound for 15 days
Peak time: ~30 min (platelet inhibition)
Administration
IV Compatibilities
Solution: D5W, Ns
Y-site: adenosine, atropine, bivalirudin, diphenhydramine, fentanyl, metoprolol, midazolam
IV Preparation
Do not add any other drugs in same IV line
Bolus injection: withdraw through 0.22 micron filter
Infusion: withdraw 4.5 mL (9 mg) through filter into syringe; inject into 250 mL of NS or D5W; final concentration 35 mcg/mL
Do not shake viaL
IV Administration
Bolus over at least 1 min
See adult dosing for infusion rate
