Therapeutic Indications

Abciximab is indicated for:

Percutaneous coronary intervention

Irrespective of gender only Adults (18 years old or older)

Abciximab is indicated as an adjunct to heparin and acetylsalicylic acid for the prevention of ischaemic cardiac complications in patients undergoing percutaneous coronary intervention (PCI: balloon angioplasty, atherectomy, and stent).

For this indication, the medical literature mentions below treatments (click for details):

Treatment 1: Intravenous - 0.25mg/kg intravenous bolus

Unstable angina

Irrespective of gender only Adults (18 years old or older)

Abciximab is indicated as an adjunct to heparin and acetylsalicylic acid for the short-term (1-month) reduction of the risk of myocardial infarction, in patients with unstable angina, not responding to full conventional therapy who have been scheduled for percutaneous coronary intervention.

For this indication, the medical literature mentions below treatments (click for details):

Treatment 1: Intravenous - 0.25mg/kg intravenous bolus

Contraindications

Active ingredient Abciximab is contraindicated in the following cases:

Severe uncontrolled hypertension

No gender/age discrimination

Abciximab is contra-indicated in the following clinical situations: active internal bleeding; history of cerebrovascular accident within two years; recent (within two months) intracranial or intraspinal surgery or trauma; recent (within two months) major surgery; intracranial neoplasm, arteriovenous malformation or aneurysm; known bleeding diathesis or severe uncontrolled hypertension; vasculitis; hypertensive retinopathy; severe hepatic failure. Since there are only limited data available, use of abciximab in severe renal failure patients requiring haemodialysis is contra-indicated.

Severe hepatic failure

No gender/age discrimination

Abciximab is contra-indicated in the following clinical situations: active internal bleeding; history of cerebrovascular accident within two years; recent (within two months) intracranial or intraspinal surgery or trauma; recent (within two months) major surgery; intracranial neoplasm, arteriovenous malformation or aneurysm; known bleeding diathesis or severe uncontrolled hypertension; vasculitis; hypertensive retinopathy; severe hepatic failure. Since there are only limited data available, use of abciximab in severe renal failure patients requiring haemodialysis is contra-indicated.

Active internal bleeding

No gender/age discrimination

Abciximab is contra-indicated in the following clinical situations: active internal bleeding; history of cerebrovascular accident within two years; recent (within two months) intracranial or intraspinal surgery or trauma; recent (within two months) major surgery; intracranial neoplasm, arteriovenous malformation or aneurysm; known bleeding diathesis or severe uncontrolled hypertension; vasculitis; hypertensive retinopathy; severe hepatic failure. Since there are only limited data available, use of abciximab in severe renal failure patients requiring haemodialysis is contra-indicated.

Arteriovenous malformation, aneurysm

No gender/age discrimination

Abciximab is contra-indicated in the following clinical situations: active internal bleeding; history of cerebrovascular accident within two years; recent (within two months) intracranial or intraspinal surgery or trauma; recent (within two months) major surgery; intracranial neoplasm, arteriovenous malformation or aneurysm; known bleeding diathesis or severe uncontrolled hypertension; vasculitis; hypertensive retinopathy; severe hepatic failure. Since there are only limited data available, use of abciximab in severe renal failure patients requiring haemodialysis is contra-indicated.

Intracranial neoplasm

No gender/age discrimination

Abciximab is contra-indicated in the following clinical situations: active internal bleeding; history of cerebrovascular accident within two years; recent (within two months) intracranial or intraspinal surgery or trauma; recent (within two months) major surgery; intracranial neoplasm, arteriovenous malformation or aneurysm; known bleeding diathesis or severe uncontrolled hypertension; vasculitis; hypertensive retinopathy; severe hepatic failure. Since there are only limited data available, use of abciximab in severe renal failure patients requiring haemodialysis is contra-indicated.

History of cerebrovascular accident within two years

No gender/age discrimination

Abciximab is contra-indicated in the following clinical situations: active internal bleeding; history of cerebrovascular accident within two years; recent (within two months) intracranial or intraspinal surgery or trauma; recent (within two months) major surgery; intracranial neoplasm, arteriovenous malformation or aneurysm; known bleeding diathesis or severe uncontrolled hypertension; vasculitis; hypertensive retinopathy; severe hepatic failure. Since there are only limited data available, use of abciximab in severe renal failure patients requiring haemodialysis is contra-indicated.

Thrombocytopenia

No gender/age discrimination

Because inhibition of platelet aggregation increases the risk of bleeding, abciximab is contra-indicated in pre-existing thrombocytopenia.

Thrombocytopenia, including severe thrombocytopenia, has been observed with abciximab administration. In clinical studies, most cases of severe thrombocytopenia (< 50,000 cells/μL) occurred within the first 24 hours of abciximab administration.

To evaluate the possibility of thrombocytopenia, platelet counts should be monitored prior to treatment, 2 to 4 hours following the bolus dose of abciximab and at 24 hours. If a patient experiences an acute platelet decrease, additional platelet counts should be determined. These platelet counts should be drawn in three separate tubes containing ethylenediaminetetraacetic acid (EDTA), citrate and heparin, respectively, to exclude pseudothrombocytopenia, due to in vitro anticoagulant interaction. If true thrombocytopenia is verified, abciximab should be immediately discontinued and the condition appropriately monitored and treated. A daily platelet count should be obtained until it returns to normal. If a patient’s platelet count drops to 60,000 cells/µL, heparin and acetylsalicylic acid should be discontinued. If a patient’s platelet count drops below 50,000 cells/µL, transfusion of platelets should be considered, especially if the patient is bleeding and/or invasive procedures are planned or ongoing. If the patient’s platelet count drops below 20,000 cells/µL, platelets should be transfused. The decision to use platelet transfusion should be based upon clinical judgment on an individual basis. Thrombocytopenia has been observed at higher rates following readministration.

Severe renal failure, dialysis

No gender/age discrimination

Use of abciximab in patients receiving dialysis is contra-indicated.

Benefits may be reduced in patients with renal disease. The use of abciximab in patients with severe renal failure should only be considered after careful appraisal of the risks and benefits. Because the potential risk of bleeding is increased in patients with severe renal disease, patients should be more frequently monitored for bleeding. In the event serious bleeding occurs, platelet transfusion should be considered. In addition, bleeding precautions should be taken into consideration.

Vasculitis

No gender/age discrimination

Abciximab is contra-indicated in the following clinical situations: active internal bleeding; history of cerebrovascular accident within two years; recent (within two months) intracranial or intraspinal surgery or trauma; recent (within two months) major surgery; intracranial neoplasm, arteriovenous malformation or aneurysm; known bleeding diathesis or severe uncontrolled hypertension; vasculitis; hypertensive retinopathy; severe hepatic failure. Since there are only limited data available, use of abciximab in severe renal failure patients requiring haemodialysis is contra-indicated.

Recent (within two months) major surgery

No gender/age discrimination

Abciximab is contra-indicated in the following clinical situations: active internal bleeding; history of cerebrovascular accident within two years; recent (within two months) intracranial or intraspinal surgery or trauma; recent (within two months) major surgery; intracranial neoplasm, arteriovenous malformation or aneurysm; known bleeding diathesis or severe uncontrolled hypertension; vasculitis; hypertensive retinopathy; severe hepatic failure. Since there are only limited data available, use of abciximab in severe renal failure patients requiring haemodialysis is contra-indicated.

Hypertensive retinopathy

No gender/age discrimination

Abciximab is contra-indicated in the following clinical situations: active internal bleeding; history of cerebrovascular accident within two years; recent (within two months) intracranial or intraspinal surgery or trauma; recent (within two months) major surgery; intracranial neoplasm, arteriovenous malformation or aneurysm; known bleeding diathesis or severe uncontrolled hypertension; vasculitis; hypertensive retinopathy; severe hepatic failure. Since there are only limited data available, use of abciximab in severe renal failure patients requiring haemodialysis is contra-indicated.