Aggrastat (tirofiban) is an antiplatelet medication that prevents blood clots from forming. It's used in certain situations to lower the risk of complications from blood clots that reach the heart for some people with serious heart conditions. Aggrastat (tirofiban) is given as a continuous infusion through the veins in the hospital, sometimes before a medical procedure to open clogged blood vessels known as percutaneous coronary intervention (PCI).
Aggrastat (tirofiban) is an antiplatelet medication, which means it prevents your platelets (cell fragments in blood) from sticking together to form a blood clot. This medication prevents platelets from clumping together by blocking proteins called glycoprotein (GP) 2b and 3a receptors that are found on the surface of platelets. By doing so, blood clots are less likely to form, get to the heart, and cause problems. As a result, Aggrastat (tirofiban) can lower the risk of complications of blood clots near the heart (e.g., heart attack, death) in people with a serious heart condition called non-ST elevation acute coronary syndrome (NSTE-ACS). A common symptom of this condition is chest pain when you're at rest.
Aggrastat (tirofiban) is typically injected into a vein by a healthcare provider. The dose of this medication depends on your weight. Some hospitals also have specific protocols that providers follow on how much Aggrastat (tirofiban) to give. The manufacturer's recommended dose is 25 mcg/kg of body weight injected in your veins over at most 5 minutes, then 0.15 mcg/kg per minute continuously for up to 18 hours. Your dose might differ if you have kidney problems. Typically, Aggrastat (tirofiban) starts preventing blood clots from forming within 10 minutes of injection when it's given at the manufacturer's recommended dose.
Receiving Aggrastat (tirofiban) can raise your risk for bleeds. Your risk is higher if you're also taking other medications that can help prevent blood clots from forming, such as heparin, clopidogrel (Plavix), or aspirin. These medications can also cause bleeding just like Aggrastat (tirofiban) can. In addition, receiving Aggrastat (tirofiban) can cause your platelet count to drop too low, which also raises your risk of bleeding. You're likely given multiple medications to help prevent blood clots from forming (and thus have high risk for bleeding) when you have a non-ST elevation acute coronary syndrome (NSTE-ACS). So, your providers will observe you very closely for any signs of bleeding while you're hospitalized. They'll also check your blood counts often. Let your provider know right away if you cough up blood or notice bleeds that are difficult to stop, especially in areas where a heart catheter or intravenous (IV) line was inserted.
During your hospital stay, you'll typically receive other medications in addition to Aggrastat (tirofiban) to protect your heart. Some examples are cholesterol medications (e.g., atorvastatin (Lipitor)), medications to prevent chest pain (e.g., nitroglycerin (Nitrostat)), and anticoagulants (e.g., heparin). In particular, anticoagulants (medications that slow down the blood clotting process) often work with antiplatelet medications to prevent blood clots from forming and causing serious heart problems. In fact, one study showed that adults who received Aggrastat (tirofiban) with heparin and aspirin were less likely to experience death, heart attack, or recurrent chest pain in the hospital than those who received heparin and aspirin only. If you have questions about the medications you're given in the hospital, talk to your provider.
The most common side effect of Aggrastat (tirofiban) is bleeding. In clinical studies, about 11% of people who were given Aggrastat (tirofiban) with heparin experienced having bloody urine, dark stool, or coughing or vomiting up coffee-ground bits. These are all signs of bleeding. Your providers will observe you very closely for any signs of bleeding during treatment with Aggrastat (tirofiban). People have also experienced pelvic pain, leg pain, slow heart rate, and dizziness after they received Aggrastat (tirofiban). Tell your provider right away if you experience any of these side effects any time after injection.
If you have kidney problems, you might be at higher risk of having side effects from Aggrastat (tirofiban), including uncontrolled bleeding. When the kidneys aren't able to get rid of the medication from your body well, the amount of medication can build up in your body and raise your risk of harmful effects. If you have kidney problems, your provider might lower how much Aggrastat (tirofiban) you get to make sure it's safe for you. In addition, because of the risk of bleeding, Aggrastat (tirofiban) isn't recommended for people who have active internal bleeding or who have had major surgery or trauma in the past month. It's also not recommended if you've had an episode of low platelets after receiving this medication in the past. Talk with a provider about your medical history before receiving Aggrastat (tirofiban).
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Aggrastat (tirofiban) will not be safe for you to take.