Thrombolytics within last 48 hours, anticoagulants Other GP llP/lla inhibitors Light molecular weight Heparins, Ticlopidine, Clopidogrel, Adenosine, Dipyridamole, Dextrans, Sulphinpyrazone, Prostacyclin, Diazepam infusion

Prevention of early MI unstable angina or non- Q wave MI with last episode of chest pain within 12 hours and with ECG changes. To be used with aspirin and unfractionated heparin under specialist supervision

Bleeding, GI postoperative , pulmonary, intracranial or retro-peritoneal bleeding, Haemopericardium, epidural haemotoma, epistaxis, gum bleeds, surface dermatorrhagia, Haematoria, bleeding from catheters sites, decrease in platelet counts, Nausea, fever,Headache, rash Severe allergic reactions

History of stroke,Haemorrhagic stroke or bleeding within last 30 days, Severe trauma, or major surgery within last 6 weeks, Thromocytopenia, platelet function disorders, clotting disorders Severe liver failure, Aneurism Pregnancy, lactation

Special Precautions-

Severe renal impairment, protracted cardiac -pulmonary resuscitation, organ biopsy or lithotripsy within last 2 weeks

Major surgery 6-12 weeks previously Active peptic ulcer within 3 months

Recent epidural procedure. Severe acute or chronic heart failure. Cardiogenic shock

Mild to moderate liver impairment. Anemia. Female elderly or low body weight patients Wihdraw immediately if patient requires thrombolytic therapy or coronary artery bypass graft Monitor blood counts after APTT before and during therapy

Monitor platelet within 1 hour if previously rrceived GPll/llb antagonists, risk of acute and severe thrombocytopaenia

To be used with aspirin and unfractionated heparin under specialist supervision

Dosage-

Initially 0.4 microgram/kg per minute by I.V. infusion for 30 minutes starting within 12 hours of the last anginal episode Then 0.1 microgram/kg minute by I.V. infusion for at least 48 hours Maximum treatment period 108 hours Children - not recommended

Pregnancy, lactation contraindicated