Identification

Name
Tirofiban
Accession Number
DB00775  (APRD00304)
Type
Small Molecule
Groups
Approved
Description

Tirofiban prevents the blood from clotting during episodes of chest pain or a heart attack, or while the patient is undergoing a procedure to treat a blocked coronary artery. It is a non-peptide reversible antagonist of the platelet glycoprotein (GP) IIb/IIIa receptor, and inhibits platelet aggregation.

Structure
Thumb
Synonyms
  • (2S)-2-(Butylsulfonylamino)-3-[4-(4-piperidin-4-ylbutoxy)phenyl]propanoic acid
  • N-(Butylsulfonyl)-O-(4-(4-piperidyl)butyl)-L-tyrosine
  • Tirofiban
  • Tirofibanum
External IDs
MK 383
Product Ingredients
IngredientUNIICASInChI Key
Tirofiban hydrochloride6H925F8O5J150915-40-5HWAAPJPFZPHHBC-FGJQBABTSA-N
Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
AggrastatInjection, solution3.75 mg/15mLIntravenousMedicure2016-10-15Not applicableUs
AggrastatSolution5 mgIntravenousCorrevio (Uk) Ltd2002-05-01Not applicableCanada
AggrastatInjection, solution5 mg/100mLIntravenousMedicure1998-05-14Not applicableUs
AggrastatLiquid0.25 mgIntravenousCorrevio (Uk) Ltd1999-09-162013-02-06Canada
International/Other Brands
Aggribloc (Abbott) / Agrastat (Merck Sharp & Dohme)
Categories
UNII
GGX234SI5H
CAS number
144494-65-5
Weight
Average: 440.597
Monoisotopic: 440.234492962
Chemical Formula
C22H36N2O5S
InChI Key
COKMIXFXJJXBQG-NRFANRHFSA-N
InChI
InChI=1S/C22H36N2O5S/c1-2-3-16-30(27,28)24-21(22(25)26)17-19-7-9-20(10-8-19)29-15-5-4-6-18-11-13-23-14-12-18/h7-10,18,21,23-24H,2-6,11-17H2,1H3,(H,25,26)/t21-/m0/s1
IUPAC Name
(2S)-2-(butane-1-sulfonamido)-3-{4-[4-(piperidin-4-yl)butoxy]phenyl}propanoic acid
SMILES
CCCCS(=O)(=O)N[C@@H](CC1=CC=C(OCCCCC2CCNCC2)C=C1)C(O)=O

Pharmacology

Indication

For treatment, in combination with heparin, of acute coronary syndrome, including patients who are to be managed medically and those undergoing PTCA or atherectomy.

Associated Conditions
Pharmacodynamics

Tirofiban prevents the blood from clotting during episodes of chest pain or a heart attack, or while the patient is undergoing a procedure to treat a blocked coronary artery. It is a non-peptide antagonist of the platelet glycoprotein (GP) IIb/IIIa receptor, and inhibits platelet aggregation. When administered intravenously, tirofiban inhibits ex vivo platelet aggregation in a dose- and concentration-dependent manner. When given according to the recommended regimen, >90% inhibition is attained by the end of the 30-minute infusion. Tirofiban has been recently shown in patients with unstable angina to reduce ischemic events at 48 hours following infusion when compared to standard heparin therapy.

Mechanism of action

Tirofiban is a reversible antagonist of fibrinogen binding to the GP IIb/IIIa receptor, the major platelet surface receptor involved in platelet aggregation. Platelet aggregation inhibition is reversible following cessation of the infusion of tirofiban.

TargetActionsOrganism
AIntegrin alpha-IIb
antagonist
Human
AIntegrin beta-3
antagonist
Human
Absorption
Not Available
Volume of distribution
  • 22 to 42 L
Protein binding

65%

Metabolism

Metabolism appears to be limited.

Route of elimination

It is cleared from the plasma largely by renal excretion, with about 65% of an administered dose appearing in urine and about 25% in feces, both largely as unchanged tirofiban.

Half life

2 hours

Clearance
  • 213 - 314 mL/min [Healthy subjects]
  • 152 - 267 mL/min [patients with coronary artery disease]
Toxicity
Not Available
Affected organisms
  • Humans and other mammals
Pathways
PathwayCategory
Tirofiban Action PathwayDrug action
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
DrugInteraction
(R)-warfarinThe risk or severity of bleeding can be increased when Tirofiban is combined with (R)-warfarin.
(S)-WarfarinThe risk or severity of bleeding can be increased when Tirofiban is combined with (S)-Warfarin.
4-hydroxycoumarinThe risk or severity of bleeding can be increased when Tirofiban is combined with 4-hydroxycoumarin.
AbacavirTirofiban may decrease the excretion rate of Abacavir which could result in a higher serum level.
AbciximabTirofiban may increase the anticoagulant activities of Abciximab.
AcarboseAcarbose may decrease the excretion rate of Tirofiban which could result in a higher serum level.
AceclofenacAceclofenac may decrease the excretion rate of Tirofiban which could result in a higher serum level.
AcemetacinAcemetacin may decrease the excretion rate of Tirofiban which could result in a higher serum level.
AcenocoumarolThe risk or severity of bleeding can be increased when Tirofiban is combined with Acenocoumarol.
AcetaminophenAcetaminophen may decrease the excretion rate of Tirofiban which could result in a higher serum level.
Food Interactions
Not Available

References

Synthesis Reference

George Roby Thomas, Dawson James Reimer, Albert D. Friesen, "TRANSDERMAL PHARMACEUTICAL PREPARATION AND ADMINISTRATION OF TIROFIBAN." U.S. Patent US20120029447, issued February 02, 2012.

US20120029447
General References
Not Available
External Links
Human Metabolome Database
HMDB0014913
KEGG Compound
C07965
PubChem Compound
60947
PubChem Substance
46504678
ChemSpider
54912
BindingDB
50004058
ChEBI
9605
ChEMBL
CHEMBL916
Therapeutic Targets Database
DAP000696
PharmGKB
PA451698
HET
AGG
RxList
RxList Drug Page
Drugs.com
Drugs.com Drug Page
Wikipedia
Tirofiban
ATC Codes
B01AC17 — Tirofiban
AHFS Codes
  • 20:12.18 — Platelet Aggregation Inhibitors
PDB Entries
2vdm
FDA label
Download (59.1 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
1CompletedTreatmentImpaired Renal Function1
1, 2Not Yet RecruitingTreatmentSubarachnoid Hemorrhage, Aneurysmal1
2CompletedTreatmentStable Angina (SA)1
2RecruitingTreatmentAcute Coronary Syndromes (ACS) / Myocardial Infarction / Unstable Angina (UA)1
2, 3RecruitingTreatmentStroke, Ischemic1
3CompletedTreatmentAcute Myocardial Infarction (AMI)1
3CompletedTreatmentST Segment Elevation Myocardial Infarction (STEMI)1
3Unknown StatusTreatmentCoronary Artery Disease1
3Unknown StatusTreatmentNon-ST Segment Elevation Acute Coronary Syndrome1
3WithdrawnTreatmentAcute Coronary Syndromes (ACS) / Myocardial Infarction / Percutaneous Coronary Intervention / Unstable Angina (UA)1
4CompletedTreatmentAcute Coronary Syndromes (ACS)1
4CompletedTreatmentAcute Myocardial Infarction (AMI)3
4CompletedTreatmentAngioplasty, Transluminal, Percutaneous Coronary1
4CompletedTreatmentCoronary Artery Disease2
4CompletedTreatmentMyocardial Infarction / Percutaneous Coronary Intervention / Thrombolytic Therapy1
4CompletedTreatmentNo-Reflow Phenomenon1
4CompletedTreatmentNon-ST Elevation Myocardial Infarction1
4RecruitingTreatmentAcute Coronary Syndromes (ACS)1
4RecruitingTreatmentCoronary Artery Disease / ST Elevation Myocardial Infarction (STEMI)1
4RecruitingTreatmentST Elevation Myocardial Infarction (STEMI)1
4TerminatedTreatmentCoronary Heart Disease (CHD)1
4Unknown StatusTreatmentAcute Myocardial Infarction (AMI)1
4Unknown StatusTreatmentCoronary Artery Disease2
Not AvailableRecruitingNot AvailableNon-ST Elevation Myocardial Infarction (NSTEMI)1
Not AvailableRecruitingPreventionElective Percutaneous Coronary Intervention / ST Segment Elevation Myocardial Infarction (STEMI)1
Not AvailableRecruitingPreventionPrimary Percutaneous Coronary Intervention / ST Segment Elevation Myocardial Infarction (STEMI)1
Not AvailableTerminatedNot AvailableAcute Coronary Syndromes (ACS) / Coronary Artery Disease1

Pharmacoeconomics

Manufacturers
  • Medicure international inc
Packagers
  • Baxter International Inc.
  • Ben Venue Laboratories Inc.
  • Guilford Pharmaceuticals
  • Iroko Pharmaceuticals
  • Medicure International Inc.
  • Merck & Co.
Dosage forms
FormRouteStrength
Injection, solutionIntravenous3.75 mg/15mL
Injection, solutionIntravenous5 mg/100mL
LiquidIntravenous0.25 mg
SolutionIntravenous5 mg
Prices
Unit descriptionCostUnit
Aggrastat 250 mcg/ml vial10.62USD ml
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)
US5658929No1993-09-272010-09-27Us
CA2234364No2000-02-082016-10-23Canada
CA2052073No1998-05-262011-09-23Canada
US6770660No2003-05-012023-05-01Us
US5965581No1996-10-232016-10-23Us
US5978698No1997-10-082017-10-08Us
US5733919No1996-10-232016-10-23Us
US5972967No1996-10-232016-10-23Us
US6136794No1999-01-292019-01-29Us

Properties

State
Solid
Experimental Properties
PropertyValueSource
water solubilityVery slightly solubleNot Available
logP1.4Not Available
Predicted Properties
PropertyValueSource
Water Solubility0.00317 mg/mLALOGPS
logP1.78ALOGPS
logP0.6ChemAxon
logS-5.1ALOGPS
pKa (Strongest Acidic)3.17ChemAxon
pKa (Strongest Basic)10.21ChemAxon
Physiological Charge0ChemAxon
Hydrogen Acceptor Count6ChemAxon
Hydrogen Donor Count3ChemAxon
Polar Surface Area104.73 Å2ChemAxon
Rotatable Bond Count13ChemAxon
Refractivity117.48 m3·mol-1ChemAxon
Polarizability49.27 Å3ChemAxon
Number of Rings2ChemAxon
Bioavailability1ChemAxon
Rule of FiveYesChemAxon
Ghose FilterYesChemAxon
Veber's RuleNoChemAxon
MDDR-like RuleNoChemAxon
Predicted ADMET features
PropertyValueProbability
Human Intestinal Absorption+0.9934
Blood Brain Barrier+0.5951
Caco-2 permeable-0.6716
P-glycoprotein substrateSubstrate0.8571
P-glycoprotein inhibitor INon-inhibitor0.5443
P-glycoprotein inhibitor IINon-inhibitor0.9898
Renal organic cation transporterNon-inhibitor0.8435
CYP450 2C9 substrateNon-substrate0.7483
CYP450 2D6 substrateNon-substrate0.7803
CYP450 3A4 substrateSubstrate0.5096
CYP450 1A2 substrateNon-inhibitor0.8569
CYP450 2C9 inhibitorNon-inhibitor0.8219
CYP450 2D6 inhibitorNon-inhibitor0.8967
CYP450 2C19 inhibitorNon-inhibitor0.7916
CYP450 3A4 inhibitorNon-inhibitor0.9023
CYP450 inhibitory promiscuityLow CYP Inhibitory Promiscuity0.9498
Ames testNon AMES toxic0.7023
CarcinogenicityNon-carcinogens0.8449
BiodegradationNot ready biodegradable0.9525
Rat acute toxicity2.3684 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.5278
hERG inhibition (predictor II)Inhibitor0.7024
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)
Not Available
Spectra
SpectrumSpectrum TypeSplash Key
Predicted GC-MS Spectrum - GC-MSPredicted GC-MSNot Available
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSNot Available

Taxonomy

Description
This compound belongs to the class of organic compounds known as phenylalanine and derivatives. These are compounds containing phenylalanine or a derivative thereof resulting from reaction of phenylalanine at the amino group or the carboxy group, or from the replacement of any hydrogen of glycine by a heteroatom.
Kingdom
Organic compounds
Super Class
Organic acids and derivatives
Class
Carboxylic acids and derivatives
Sub Class
Amino acids, peptides, and analogues
Direct Parent
Phenylalanine and derivatives
Alternative Parents
Phenylpropanoic acids / Amphetamines and derivatives / Phenoxy compounds / Phenol ethers / Alkyl aryl ethers / Piperidines / Organosulfonamides / Organic sulfonamides / Aminosulfonyl compounds / Amino acids
show 8 more
Substituents
Phenylalanine or derivatives / 3-phenylpropanoic-acid / Amphetamine or derivatives / Phenoxy compound / Phenol ether / Alkyl aryl ether / Monocyclic benzene moiety / Piperidine / Benzenoid / Organosulfonic acid amide
show 24 more
Molecular Framework
Aromatic heteromonocyclic compounds
External Descriptors
piperidines, sulfonamide, L-tyrosine derivative (CHEBI:9605)

Targets

Kind
Protein
Organism
Human
Pharmacological action
Yes
Actions
Antagonist
General Function
Metal ion binding
Specific Function
Integrin alpha-IIb/beta-3 is a receptor for fibronectin, fibrinogen, plasminogen, prothrombin, thrombospondin and vitronectin. It recognizes the sequence R-G-D in a wide array of ligands. It recogn...
Gene Name
ITGA2B
Uniprot ID
P08514
Uniprot Name
Integrin alpha-IIb
Molecular Weight
113375.96 Da
References
  1. Theroux P, Alexander J Jr, Pharand C, Barr E, Snapinn S, Ghannam AF, Sax FL: Glycoprotein IIb/IIIa receptor blockade improves outcomes in diabetic patients presenting with unstable angina/non-ST-elevation myocardial infarction: results from the Platelet Receptor Inhibition in Ischemic Syndrome Management in Patients Limited by Unstable Signs and Symptoms (PRISM-PLUS) study. Circulation. 2000 Nov 14;102(20):2466-72. [PubMed:11076818]
  2. Dickfeld T, Ruf A, Pogatsa-Murray G, Muller I, Engelmann B, Taubitz W, Fischer J, Meier O, Gawaz M: Differential antiplatelet effects of various glycoprotein IIb-IIIa antagonists. Thromb Res. 2001 Jan 15;101(2):53-64. [PubMed:11342206]
  3. von Segesser LK, Mueller X, Marty B, Horisberger J, Corno A: Alternatives to unfractionated heparin for anticoagulation in cardiopulmonary bypass. Perfusion. 2001 Sep;16(5):411-6. [PubMed:11565896]
  4. Kondo K, Umemura K: Clinical pharmacokinetics of tirofiban, a nonpeptide glycoprotein IIb/IIIa receptor antagonist: comparison with the monoclonal antibody abciximab. Clin Pharmacokinet. 2002;41(3):187-95. [PubMed:11929319]
  5. Roffi M, Moliterno DJ, Meier B, Powers ER, Grines CL, DiBattiste PM, Herrmann HC, Bertrand M, Harris KE, Demopoulos LA, Topol EJ: Impact of different platelet glycoprotein IIb/IIIa receptor inhibitors among diabetic patients undergoing percutaneous coronary intervention: : Do Tirofiban and ReoPro Give Similar Efficacy Outcomes Trial (TARGET) 1-year follow-up. Circulation. 2002 Jun 11;105(23):2730-6. [PubMed:12057986]
  6. Juwana YB, Suryapranata H, Ottervanger JP, van 't Hof AW: Tirofiban for myocardial infarction. Expert Opin Pharmacother. 2010 Apr;11(5):861-6. doi: 10.1517/14656561003690005. [PubMed:20210689]
Details
2. Integrin beta-3
Kind
Protein
Organism
Human
Pharmacological action
Yes
Actions
Antagonist
General Function
Virus receptor activity
Specific Function
Integrin alpha-V/beta-3 (ITGAV:ITGB3) is a receptor for cytotactin, fibronectin, laminin, matrix metalloproteinase-2, osteopontin, osteomodulin, prothrombin, thrombospondin, vitronectin and von Wil...
Gene Name
ITGB3
Uniprot ID
P05106
Uniprot Name
Integrin beta-3
Molecular Weight
87056.975 Da
References
  1. Chen X, Ji ZL, Chen YZ: TTD: Therapeutic Target Database. Nucleic Acids Res. 2002 Jan 1;30(1):412-5. [PubMed:11752352]
  2. Berman HM, Westbrook J, Feng Z, Gilliland G, Bhat TN, Weissig H, Shindyalov IN, Bourne PE: The Protein Data Bank. Nucleic Acids Res. 2000 Jan 1;28(1):235-42. [PubMed:10592235]
  3. Juwana YB, Suryapranata H, Ottervanger JP, van 't Hof AW: Tirofiban for myocardial infarction. Expert Opin Pharmacother. 2010 Apr;11(5):861-6. doi: 10.1517/14656561003690005. [PubMed:20210689]

Drug created on June 13, 2005 07:24 / Updated on November 14, 2018 12:46