Assessment of eptifibatide clearance by hemodialysis using an in vitro system.

Background/aims: Eptifibatide is a parenteral glycoprotein IIb-IIIa inhibitor that prevents platelet aggregation. Although contraindicated in dialysis patients due to limited safety and dialysis data, eptifibatide is prescribed in this population and is associated with bleeding complications. This study was done to determine dialysis clearance (CL(D)) of eptifibatide using an in vitro system.

Fluconazole-carbamazepine interaction.

The patient we describe had elevated carbamazepine serum concentrations during concomitant fluconazole administration (400 mg/day), including serial concentrations both before and after antifungal therapy. Since fluconazole is a known inhibitor of the cytochrome P450 enzyme system, this suggests an inhibition of carbamazepine metabolism.