Eptifibatide
GPIIb/IIIa inhibitor
Also Integrilin, Eptifibatide injection
- Evidence
- AStrong human evidence
- FDA status
- FDA approvedas of 2026-10-26
- Route
- Intravenous
- Studies cited
- 1 human1 animal or cell
It is a hospital drug that stops clots in people having a heart attack or a stent put in. A trial of 10,948 people showed a small drop in deaths and heart attacks, with more bleeding.
Sold for
Eptifibatide is a hospital anticlotting drug, derived from rattlesnake venom, used during heart attacks and stent procedures.
Studies say
A 10,948-patient placebo-controlled trial showed a modest reduction in death or heart attack with more bleeding, which is an A for its approved use.
Why grade A. The acute coronary syndrome indication rests on PURSUIT, a randomized, double-blind, placebo-controlled trial of 10,948 patients, with supporting trials in PCI (IMPACT-II, ESPRIT) summarized in the label. The absolute benefit is small, about 1.5 percentage points fewer deaths or heart attacks at 30 days, and comes at the cost of more bleeding. 23
FDA. Approved. Eptifibatide was approved by the FDA in 1998 as Integrilin for acute coronary syndrome, including patients managed medically and those undergoing percutaneous coronary intervention, and for patients undergoing PCI. It is given intravenously in hospital. Generic eptifibatide is available. 3
Written from 3 cited sources. Last refreshed 2026-10-27. Not physician reviewed.
What this means for you
- What people take it for
- Preventing clots in heart attack and stenting
- Can a US doctor prescribe it?
- Yes, FDA approved for heart attack-type chest pain and stenting.
- Properly tested in people?
- Yes, in large controlled trials. The main trial had 10,948 people.
Evidence checklist
- Randomised controlled trial PURSUIT placebo-controlled trialyes
- Human study over 100 people PURSUIT, 10,948 patientsyes
- More than one research group PURSUIT plus IMPACT-II and ESPRITyes
- Clinical outcomes, not surrogate markers Death or heart attack at 30 daysyes
- Human safety data beyond case reports Bleeding and platelet drop documented in labelyes
Drawn from the cited studies below. A dash means the sources give no information.
What it is
Eptifibatide is a cyclic seven-amino-acid peptide modeled on barbourin, a protein in the venom of the southeastern pygmy rattlesnake. In 1991 researchers screening 62 snake venoms found that barbourin was the only one that blocked the platelet receptor GPIIb/IIIa without also blocking related integrins on other cells, a selectivity traced to a single lysine-for-arginine substitution in the binding motif. Eptifibatide copies that motif in a small, stable ring. 1
It was approved in 1998 as Integrilin, developed by COR Therapeutics and later sold by Schering-Plough and Merck. It is one of three intravenous GPIIb/IIIa inhibitors, alongside abciximab (now discontinued) and tirofiban, and is used in catheterization labs and coronary care units. 3
How it works
GPIIb/IIIa is the receptor on the platelet surface that binds fibrinogen and links platelets to each other, the final common step of clot formation regardless of what triggered it. Eptifibatide occupies that receptor reversibly, so platelets can be activated but cannot aggregate. Its effect wears off within a few hours of stopping the infusion because the drug is cleared by the kidneys and dissociates from the receptor, which is an advantage if a patient needs urgent surgery. 13
What human research shows
PURSUIT randomized 10,948 patients with unstable angina or non-ST-elevation heart attack to eptifibatide or placebo on top of aspirin and heparin for up to 72 hours. At 30 days, death or heart attack had occurred in 14.2% of eptifibatide patients and 15.7% of placebo patients, an absolute reduction of 1.5 percentage points that was statistically significant and already visible at 96 hours. The benefit was concentrated in patients who went on to have a coronary intervention. 2
Bleeding was the trade-off: major bleeding and red-cell transfusions were more frequent on eptifibatide, though hemorrhagic stroke was not. Later PCI trials summarized in the label confirmed fewer ischemic complications around stent procedures, which is where the drug is mostly used today, as oral antiplatelet drugs have reduced its role in medically managed patients. 23
| Study | Model | Finding |
|---|---|---|
| Barbourin discovery 1991 | Screening of 62 snake venoms, in vitro platelet assays | Barbourin from the pygmy rattlesnake was the only venom peptide selective for GPIIb/IIIa, owing to a KGD motif in place of the usual RGD. 1 |
| PURSUIT | Humans, n=10,948, randomized double-blind placebo-controlled, acute coronary syndrome | Death or heart attack at 30 days was 14.2% versus 15.7% on placebo, with more bleeding. 2 |
| Integrilin prescribing information | FDA label | Approved for acute coronary syndrome and PCI; bleeding and thrombocytopenia are the main warnings. 3 |
Safety
Bleeding is the principal risk, especially at the arterial puncture site after catheterization, and the label contraindicates the drug in patients with recent major bleeding, severe hypertension, recent stroke or a bleeding disorder. Thrombocytopenia (a sharp fall in platelet count) occurs in a small percentage of patients and requires platelet monitoring. Dose adjustment is needed in kidney impairment because the drug is cleared by the kidneys. 3
Questions for your clinician
- How much does it cut my risk of death or heart attack, and what is the bleeding trade-off?
- Will my platelet count be checked?
- Does my kidney function change how it is given?
Questions people ask
Is eptifibatide FDA-approved?
Yes, since 1998, for acute coronary syndrome and for patients undergoing percutaneous coronary intervention. It is a hospital-only intravenous drug. 3
Is eptifibatide really made from snake venom?
It is a synthetic peptide designed from barbourin, a protein in pygmy rattlesnake venom. No venom is used in manufacturing. 1
How much does eptifibatide help?
In PURSUIT it prevented roughly 15 deaths or heart attacks per 1,000 patients treated over 30 days, at the cost of more bleeding and transfusions. The benefit was largest in patients who had a coronary intervention. 2
What are the main risks?
Bleeding, particularly at catheter sites, and a small risk of a sudden drop in platelet count. The effect reverses within hours of stopping the infusion. 3
Citations
- Scarborough 1991, Journal of Biological Chemistry: barbourin, a GPIIb-IIIa-specific integrin antagonist from pygmy rattlesnake venom pubmed.ncbi.nlm.nih.gov
- PURSUIT Trial Investigators 1998, NEJM: inhibition of platelet glycoprotein IIb/IIIa with eptifibatide in acute coronary syndromes doi.org
- Merck: Integrilin (eptifibatide) prescribing information merck.com