Evidence memo / Cardiovascular & antithrombotic

Eptifibatide

Also: Integrilin

Eptifibatide (Integrilin) is a glycoprotein IIb/IIIa inhibitor, an antiplatelet peptide approved for acute coronary syndrome and for patients undergoing percutaneous coronary intervention. It is given in the hospital. The approved use is specific. The Watchlist boundary is keeping it to its procedural and acute-coronary role and noting bleeding and low-platelet risks.

Approved for specific usesPost-market evidenceSafety / regulatory watch

The verdict

Our read at a glance.

Whether eptifibatide's approved antiplatelet role in acute coronary syndrome and PCI is understood within that specific setting, rather than generalized.

The signal
Randomized trials, including PURSUIT and ESPRIT, supported eptifibatide for reducing ischemic events in acute coronary syndrome and during percutaneous coronary intervention. Bleeding is the main trade-off, and its use has evolved with newer oral antiplatelet drugs.
The unknown
Its place now that potent oral antiplatelet agents are standard, and the best patient selection to balance ischemic benefit against bleeding.
Our read
A hospital antiplatelet drug for acute heart events, not something used outside that setting. Eptifibatide has real trial support in acute coronary syndrome and PCI, with bleeding as the central trade-off.

The mechanism

How it works.

Eptifibatide is a synthetic cyclic peptide that plugs the glycoprotein IIb/IIIa receptor on the surface of platelets. That receptor is the final common step platelets use to bind fibrinogen and link to each other, so blocking it stops platelets from clumping into a clot no matter what triggered them. It is given by IV during acute coronary events and stenting and reverses within hours once the drug is stopped.

Safety & regulatory boundary

The consequential part.

Eptifibatide increases bleeding risk and can cause thrombocytopenia (low platelets), and it is contraindicated in several bleeding-related situations. It is a hospital-administered drug for specific acute cardiology indications. Integrilin and other eptifibatide products are not the same as compounded or research-labeled eptifibatide, and the approved use does not extend to any general or wellness setting.

What's next

What we're watching.

Its evolving role alongside oral antiplatelet drugs, and patient-selection and bleeding-management data.

Context

Why this is discussed.

Eptifibatide is one of the intravenous antiplatelet agents used in acute heart conditions and during stenting.

The evidence base

23 cited references.

Regulatory & labels3

DailyMed label: Eptifibatide

Eugia US LLC (FDA label) · 2024

DailyMed label: Eptifibatide

Slate Run Pharmaceuticals, LLC (FDA label) · 2026

DailyMed label: Eptifibatide

Meitheal Pharmaceuticals Inc. (FDA label) · 2024

Indexed literature (PubMed)12

Targeting integrin pathways: mechanisms and advances in therapy

Pang X et al. · Signal Transduct Target Ther · 2023

Eptifibatide

PubMed · 2006

Anti-integrin therapy

Hamm CW · Annu Rev Med · 2003

Eptifibatide overdose

Parakh S et al. · Int J Cardiol · 2009

Keep reading

Related published memos.