Which GP IIb/IIIa inhibitor requires dose adjustment when CrCl <50 mL/min?

• A. Eptifibatide
• B. Abciximab
• C. Tirofiban
• D. None

Answer: (A)

Renal clearance drives how we adjust dosing for some GP IIb/IIIa inhibitors. When kidney function falls, drugs that are cleared by the kidneys can accumulate and raise bleeding risk, so dosing must be changed accordingly.

Eptifibatide is eliminated mainly by the kidneys. If creatinine clearance drops below about 50 mL/min, the maintenance infusion should be reduced to avoid excessive exposure. That explicit need for dose adjustment at CrCl <50 mL/min is why this drug is the best answer.

Abciximab, in contrast, is a monoclonal antibody fragment cleared largely by proteolysis through the reticuloendothelial system, not primarily by the kidneys, so renal impairment does not necessitate a dose adjustment for this agent.

Tirofiban is also renally cleared, but the specific dosing adjustment thresholds differ and are not the focus of this question. The key teaching point here is that one of these agents has a clear, renal-function–based adjustment requirement at CrCl <50 mL/min, and that is eptifibatide.