Skip to main content
Journal cover image

Pharmacosimulation of delays and interruptions during administration of tirofiban: a systematic comparison between EU and US dosage regimens.

Publication ,  Journal Article
Heramvand, N; Masyuk, M; Muessig, JM; Nia, AM; Karathanos, A; Polzin, A; Valgimigli, M; Gurbel, PA; Tantry, US; Kelm, M; Jung, C
Published in: J Thromb Thrombolysis
August 2022

Tirofiban is a glycoproteine (GP) IIb/IIIa receptor antagonist, which inhibits platelet-platelet aggregation and is a potential adjunctive antithrombotic treatment in patients with acute coronary syndromes (ACS) or high-risk percutaneous coronary interventions (PCI). It is administered intravenously as a bolus followed by continuous infusion. However, the dosage recommendations in the United States (US) and European Union (EU) differ considerably. Furthermore, in routine clinical practice, deviations from the recommendations may occur. The objective of the present study was to investigate the impact of different alterations on tirofiban plasma concentrations in US and EU administration regimens and to give suggestions for delay management in clinical practice. We therefore mathematically simulated the effects of different bolus-infusion delays and infusion interruptions in different scenarios according to the renal function. Here, we provide a systematic assessment of concentration patterns of tirofiban in the US versus EU dosage regimens. We show that differences between the two regimens have important effects on plasma drug levels. Furthermore, we demonstrate that deviations from the proper administration mode affect the concentration of tirofiban. Additionally, we calculated the optimal dosage of a second bolus to rapidly restore the initial concentration without causing overdosage. In conclusion, differences in tirofiban dosing regimens between the U.S and EU and potential infusion interruptions have important effects on drug levels that may impact on degrees of platelet inhibition and thus antithrombotic effects. Thus, the findings of our modelling studies may help to explain differences in clinical outcomes observed in previous clinical trials on tirofiban.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

J Thromb Thrombolysis

DOI

EISSN

1573-742X

Publication Date

August 2022

Volume

54

Issue

2

Start / End Page

301 / 308

Location

Netherlands

Related Subject Headings

  • Tyrosine
  • Tirofiban
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • Platelet Aggregation Inhibitors
  • Percutaneous Coronary Intervention
  • Humans
  • Fibrinolytic Agents
  • European Union
  • Cardiovascular System & Hematology
  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Heramvand, N., Masyuk, M., Muessig, J. M., Nia, A. M., Karathanos, A., Polzin, A., … Jung, C. (2022). Pharmacosimulation of delays and interruptions during administration of tirofiban: a systematic comparison between EU and US dosage regimens. J Thromb Thrombolysis, 54(2), 301–308. https://doi.org/10.1007/s11239-022-02654-0
Heramvand, Nadia, Maryna Masyuk, Johanna M. Muessig, Amir M. Nia, Athanasios Karathanos, Amin Polzin, Marco Valgimigli, et al. “Pharmacosimulation of delays and interruptions during administration of tirofiban: a systematic comparison between EU and US dosage regimens.J Thromb Thrombolysis 54, no. 2 (August 2022): 301–8. https://doi.org/10.1007/s11239-022-02654-0.
Heramvand N, Masyuk M, Muessig JM, Nia AM, Karathanos A, Polzin A, et al. Pharmacosimulation of delays and interruptions during administration of tirofiban: a systematic comparison between EU and US dosage regimens. J Thromb Thrombolysis. 2022 Aug;54(2):301–8.
Heramvand, Nadia, et al. “Pharmacosimulation of delays and interruptions during administration of tirofiban: a systematic comparison between EU and US dosage regimens.J Thromb Thrombolysis, vol. 54, no. 2, Aug. 2022, pp. 301–08. Pubmed, doi:10.1007/s11239-022-02654-0.
Heramvand N, Masyuk M, Muessig JM, Nia AM, Karathanos A, Polzin A, Valgimigli M, Gurbel PA, Tantry US, Kelm M, Jung C. Pharmacosimulation of delays and interruptions during administration of tirofiban: a systematic comparison between EU and US dosage regimens. J Thromb Thrombolysis. 2022 Aug;54(2):301–308.
Journal cover image

Published In

J Thromb Thrombolysis

DOI

EISSN

1573-742X

Publication Date

August 2022

Volume

54

Issue

2

Start / End Page

301 / 308

Location

Netherlands

Related Subject Headings

  • Tyrosine
  • Tirofiban
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • Platelet Aggregation Inhibitors
  • Percutaneous Coronary Intervention
  • Humans
  • Fibrinolytic Agents
  • European Union
  • Cardiovascular System & Hematology
  • 3202 Clinical sciences