Pharmacology · Antiplatelet drugs
Abciximab !
An antibody fragment given by vein that blocks the platelet glycoprotein IIb/IIIa receptor during coronary angioplasty. Its effect outlasts the infusion.
Updated 2026-11-01
The figure shows human integrin αIIbβ3 with the abciximab antibody fragment bound; abciximab is a protein, so no small-molecule ligand is marked.
Mechanism of action
Abciximab is the Fab fragment of a monoclonal antibody against glycoprotein IIb/IIIa, the receptor through which fibrinogen and von Willebrand factor link platelets together. Bound to the receptor, it blocks this final common step of aggregation. It also binds the vitronectin receptor on platelets, endothelial cells and smooth muscle cells.
- The abciximab Fab binds glycoprotein IIb/IIIa
- Fibrinogen and von Willebrand factor can no longer bridge platelets
- It stays on platelets, so the effect outlasts the infusion
Pharmacokinetics
- Half-life
- Free antibody about 30 minutes, but it stays bound to platelets.
- Onset and duration
- Immediate by vein; platelet aggregation remains inhibited for 18 to 24 hours after the infusion.
Indications
- Percutaneous coronary intervention, together with aspirin and heparin, to prevent ischaemic complications. Myocardial Infarction (Heart Attack) →
Adverse effects
Common
- Bleeding, the main adverse effect
Contraindications
- Active bleeding or bleeding tendency
- Previous intracranial haemorrhage or a known cerebral vascular lesion
- Recent ischaemic stroke or significant head trauma
- Contraindications similar to those of fibrinolytic therapy
Key interactions
- Heparin
- More intense heparin anticoagulation increases major bleeding.
- Other antiplatelets, anticoagulants and fibrinolytics
- Add to the risk of bleeding.
What is monitored
- Platelet count, to detect thrombocytopenia (pseudothrombocytopenia from clumping is ruled out)
- Haemoglobin and access-site bleeding
- aPTT or ACT when heparin is given together
Administration and safety
- Intravenous bolus followed by a continuous infusion during and after PCI
- In major bleeding, platelet transfusion can help, because little free antibody remains after the infusion
- Previous exposure is checked: re-administration raises the risk of reactions
Nursing care
- Ask whether the patient has received abciximab before
- Check platelets early and repeat as planned
- Watch the access site and look for bleeding in gums, urine and stools
- Keep punctures to a minimum during and after the infusion
Pregnancy and breastfeeding
Information in pregnancy is limited; it is used only when clearly needed.
Test yourself
Think of the answer, then tap the question to see it.
Why does abciximab's antiplatelet effect last much longer than its plasma half-life?
The free antibody disappears in about 30 minutes, but the Fab stays bound to platelet glycoprotein IIb/IIIa and inhibits aggregation for 18 to 24 hours.
Which glycoprotein IIb/IIIa blocker is an antibody, which a cyclic peptide and which a small non-peptide molecule?
Abciximab is an antibody Fab fragment, eptifibatide a cyclic peptide and tirofiban a small non-peptide molecule.
Why can platelet transfusion help in bleeding after abciximab?
Free antibody levels fall rapidly after the infusion, so newly transfused platelets are not blocked.
Related drugs
Related conditions
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Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: 6V4P: Structure of the integrin AlphaIIbBeta3-Abciximab complex (RCSB Protein Data Bank, 2020); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 36 (McGraw Hill, 2023).
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Representative model, for educational purposes only.