Adult Dosing
Percutaneous coronary intervention
- Start: 0.25 mg/kg IV bolus 10-60 mins before PCI
- Maintenance 0.125 mcg/kg/min IV x 12 hrs; Max: 10 mcg/min
Panned PCI in unstable angina not responding to conventional medical therapy
- Start: 0.25 mg/kg IV bolus, followed by 10 mcg/min IV x 18-24 hrs, concluding 1 hour post-PCI
Note:
- Administer with heparin and aspirin
Acute Coronary Syndromes [Non-FDA Approved]
- 0.25 mg/kg IV bolus followed by 0.125 mcg/kg/min (max 10 mcg/min)
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been studied
[Outline]
- Abciximab increases the risk of bleeding particularly in patients receiving thrombolytics or other anticoagulants, should be used if potential benefit outweighs the risk and if serious bleeding occurs immediately stop the abciximab infusion and concomitant heparin
- To minimize the risk of bleeding, use low dose, weight adjusted heparin dose, and follow strict anticoagulation guidelines, discontinue heparin after the procedure and remove femoral arterial sheath early (within six hours)
- Carefully monitor the potential bleeding sites including catheter insertion sites, arterial and venous puncture sites, cutdown sites, needle puncture sites, and gastrointestinal, genitourinary, pulmonary and retroperitoneal sites
- Apply pressure to the femoral artery for at least 30 minutes following the sheath removal, and apply pressure dressing, maintain patient on bed rest for 6-8 hrs, and check frequently the sheath insertion site and distal pulses of affected leg(s)
- Allergic reactions sometimes fatal have been reported with abciximab therapy, discontinue the treatment and initiate resuscitative measures if such reactions occur
- As abciximab inhibits platelet aggregation, use cautiously with other drugs that affect hemostasis, including thrombolytics, oral anticoagulants, non-steroidal anti-inflammatory drugs, dipyridamole, and ticlopidine
- Abciximab can cause thrombocytopenia, monitor platelet counts prior to, during, and after treatment, if true thrombocytopenia is verified immediately discontinue abciximab and provide appropriate treatment
- Evaluate pre-existing hemostatic abnormalities by measuring prothrombin time, ACT, APTT, and platelet count before starting abciximab therapy
- Maintain APTT between 60-85 seconds during the Abciximab and heparin infusion period, and ACT between 200-300 seconds during PCI, If anticoagulation is continued following PCI, the APTT should be maintained between 55-75 seconds.
- The arterial sheat should not be removed unless APTT
50 seconds or ACT 175 seconds - Readministration of abciximab results in the formation of HACA, that can cause allergic or hypersensitivity reactions, thrombocytopenia or diminished benefit upon readministration
Cautions: Use cautiously in
- Concomitant use with other anticoagulants or thrombolytic agents
- History of GI pathology
Pregnancy Category:C
Breastfeeding: Safety unknown. Manufacturer advises caution.
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