Drug Discontinuation

HPS Pharmacies wish to advise that Janssen-Cilag has given notice of the discontinuation of:

ReoPro® Injection
Abciximab 10mg/5mL
ARTG 48864

ReoPro® will be discontinued from the market on 15th July 2018.

Abciximab is a glycoprotein IIb/IIIa inhibitor indicated for the prevention of ischaemic complications in patients undergoing percutaneous coronary intervention (PCI) and in patients with unstable angina who are likely to undergo PCI.

Other glycoprotein IIb/IIIa inhibitors currently available in Australia are eptifibatide (Integrilin®) and tirofiban (Aggrastat®). Compared to the monoclonal antibody abciximab, these small molecule agents have a rapid onset and a short plasma half-life. Bivalirudin is an anticoagulant also indicated for patients undergoing PCI and for the treatment of acute coronary syndromes in patients undergoing early invasive management. The Therapeutic Guidelines recommend consideration of bivalirudin for patients at high risk of bleeding.

A brief comparison of these agents is shown in Table 1.

Drug Duration of Effect* Renal Dose Adjustments HACA** Formation
Antiplatelet

Abciximab

24-48 hours

Not required

Yes
(5-6% single administration)

Eptifibatide

Within 4 hours

Reduce dose if CrCl<50 ml/minute

No

Tirofiban

Within 4-8 hours

Reduce dose if CrCl<30ml/min

No

Anticoagulant

Bivalirudin

~2 hours

Reduce dose if CrCl<30ml/min

No

*Duration of effect given as time to return of normal platelet function for antiplatelet agents and time to return of sub-therapeutic coagulation times for bivalirudin.
**Human anti-chimeric antibodies.

Table 1. Comparison of medications used in PCI

Additional information is available in the Therapeutic Guidelines: Cardiovascular. The appropriate product information should be consulted for further information before an alternative agent is selected.

Your HPS Pharmacies Pharmacy Manager/Director of Pharmacy will contact your facility and clinicians if there is an immediate impact to your facility.

Retain this notice in a prominent position, including in other related business units until supplies return to normal. Report any problems identified with medicines, vaccines or medical devices to the TGA.

Should you require further information regarding this matter, please contact your pharmacist at HPS Pharmacies, or Janssen-Cilag on 1800 226 334.

References:

  1. Cardiovascular Expert Group. Acute coronary syndromes [revised 2018 March]. In: eTG complete [Online]. Melbourne: Therapeutic Guidelines Limited; 2018.
  2. Rossi S, editor. Blood and electrolytes. In: Australian Medicines Handbook 2018 [online]. Adelaide: Australian Medicines Handbook Pty Ltd; 2018.

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