This page shows what was measured, who it was measured in, and what that does not settle.
What Tirofiban does in the body
Tirofiban blocks the receptor itself, which is the door every signal has to go through.
Platelets stick to each other by putting out a receptor that grabs a bridging protein called fibrinogen — one platelet at each end, and the clot builds from there. Many different signals can make a platelet put that receptor out, so blocking any single signal only closes one door. It is given into a vein, works within about ten minutes, and its effect fades within a few hours of stopping the drip. It is cleared mainly by the kidneys.
Why people take it. Preventing clots during unstable chest pain and some heart attacks.
What happened in people
Added to heparin and aspirin, it reduced early heart problems, but one later study’s benefit disappeared within a month.
✓ Reviewed first-read answer
Where this came from
A person wrote this and a reviewer approved it against this exact record. It carries no effect size.
A reviewer approved this against this record. The reviewed-claim record carrying the exact population and effect size does not exist yet.
No source is stored against this line.
The limit that matters most
The dose used today was not the dose tested in the key studies.
Where it acts
The glycoprotein IIb/IIIa receptors on the surface of circulating platelets, and the coronary artery lumen during a procedure
Kind of result
The kind of result is not recorded
Supervision
RNAWiki has not recorded a supervision or regulatory status for this substance.
What the registries record it as
The substance registry classes this as chemical.
FDA substance registry · 6H925F8O5J · read 2026-08-29
Its recorded molecular formula is C22H36N2O5S•HCl, weighing 495.08.
US prescribing information · fe0ced75-ccbf-4d2e-bd0d-b57e60ab913f · read 2026-08-30
Where each sentence above came from
A person wrote this explanation into the record, with the studies named in the path below.
A reviewer approved this sentence against this exact record and its sources.
The limit a reviewer approved as the one that matters most here.
The four opening statements run to 122 words.
Words this page uses
Four words worth knowing first
Chosen from what this page shows, with each one explained before the word it depends on.
Comparator
A comparator is whatever the treatment was measured against.
A picture of it, and where the picture fails
It is like the other runner in a race.
Where that stops being true. A race has one winner. A study can show both arms improved.
What people get wrong. Results are read without asking what the other group got. Beating nothing is not beating a treatment.
The control condition against which the experimental intervention is assessed.
Randomisation
Randomisation means chance decides who gets which treatment.
A picture of it, and where the picture fails
It is like a coin toss deciding the groups.
Where that stops being true. A coin toss is fair once. Fairness here comes from doing it for everyone.
What people get wrong. It is thought to make groups identical. It makes them similar on average, including on things nobody measured.
Allocation of participants to arms by a chance process, so that unmeasured factors are balanced in expectation.
Absolute difference
An absolute difference is how many more people in a hundred were affected.
A picture of it, and where the picture fails
It is like counting heads in two rooms of a hundred.
Where that stops being true. Heads are easy to count. Study results carry a margin of error too.
What people get wrong. It is confused with a percentage change, which can look far larger.
The arithmetic difference in event rates between arms.
Confidence interval
A confidence interval is the range the true answer is likely to sit in.
A picture of it, and where the picture fails
It is like a weather forecast giving a range rather than one number.
Where that stops being true. A forecast range covers tomorrow. This one covers what the study could resolve.
What people get wrong. The middle number is read as the answer. A range crossing zero means no change is still possible.
An interval estimate that would contain the true parameter in a stated proportion of repeated studies.
What happened in people◇Read from sources, not yet reviewed
What happened in people
Each card is one study: the exact question it asked, who was in it, and whether it showed what it set out to show.
Composite of death, myocardial infarction or refractory ischaemia within seven days, tirofiban plus heparin versus heparin alone versus tirofiban alone, in unstable angina or non-Q-wave myocardial infarction
✓ The study showed what it set out to show
Who was studied
PRISM-PLUS
How many people
1915
Study design
Phase 3 randomised double-blind three-arm trial, mean 71.3 hours of infusion
Compared against
Not recorded for this study
Kind of result
Living longer, or avoiding a major event
What was found
12.9% vs 17.9%, risk ratio 0.68 (95% CI 0.53 to 0.88), p=0.004. Sustained at 30 days (18.5% vs 22.3%, p=0.03) and 6 months (27.7% vs 32.1%, p=0.02)
Repeated elsewhere
Partially Replicated
What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.
The limits of this study, and where it came from
Main limit. The tirofiban-alone arm was terminated early for excess seven-day mortality, 4.6% against 1.1% on heparin alone. Major bleeding was 4.0% against 3.0% (p=0.34).
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Intravenous bolus and infusion from a premixed bag, hospital use only
Interval reported. 95% CI 0
Written into the record, not signed off as a reviewed claim.
3.8% vs 5.6%, risk ratio 0.67 (95% CI 0.48 to 0.92), p=0.01 at 48 hours. At 30 days 15.9% vs 17.1%, p=0.34 — no difference
Repeated elsewhere
Partially Replicated
What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.
The limits of this study, and where it came from
Main limit. Death or myocardial infarction at 30 days 5.8% vs 7.1% (p=0.11), not significant, while mortality alone was 2.3% vs 3.6% (p=0.02). Reversible thrombocytopenia 1.1% vs 0.4% (p=0.04). Only 1.9% underwent revascularisation in the first 48 hours.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Intravenous bolus and infusion from a premixed bag, hospital use only
Interval reported. 95% CI 0
Written into the record, not signed off as a reviewed claim.
Composite of death, nonfatal myocardial infarction or urgent target-vessel revascularisation at 30 days, tirofiban versus abciximab in percutaneous coronary revascularisation with intent to stent
7.6% (2398 patients) vs 6.0% (2411 patients), hazard ratio 1.26, two-sided 95% CI 1.01 to 1.57, p=0.038 — non-inferiority not shown and abciximab demonstrated superior
Repeated elsewhere
Unreplicated
What this does not prove. A study that did not show an effect does not show that no effect exists anywhere.
The limits of this study, and where it came from
Main limit. Every component moved the same way, with myocardial infarction 6.9% vs 5.4% (p=0.04). Tirofiban had less minor bleeding and less thrombocytopenia. The bolus dose used has since been argued to have been too low, which is the origin of the current labelled regimen.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Intravenous bolus and infusion from a premixed bag, hospital use only
Interval reported. 95% CI 1
Written into the record, not signed off as a reviewed claim.
Modified Rankin scale score of 0 or 1 at 90 days, two days of intravenous tirofiban versus oral aspirin, in ischaemic stroke without large or medium-sized vessel occlusion
✓ The study showed what it set out to show
Who was studied
RESCUE BT2 (ChiCTR2000029502)
How many people
1177
Study design
Multicentre randomised double-blind double-dummy trial in China, 90-day endpoint
Compared against
Not recorded for this study
Kind of result
A number that stands in for health
What was found
29.1% (606 patients) vs 22.2% (571 patients), adjusted risk ratio 1.26 (95% CI 1.04 to 1.53), p=0.02
Repeated elsewhere
Unreplicated
What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.
The limits of this study, and where it came from
Main limit. The publication states that results for secondary endpoints were generally not consistent with the primary analysis. Symptomatic intracranial haemorrhage 1.0% vs 0%. Four distinct clinical presentations were enrolled, and the trial was conducted entirely in China.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Intravenous bolus and infusion from a premixed bag, hospital use only
Interval reported. 95% CI 1
Written into the record, not signed off as a reviewed claim.
RNAWiki holds 4 written-up human studies for this substance, each with the question it asked.
How we know it
Each card names the study, the number of people and what the study set out to measure.
What this does not prove
These summaries were written by a person and have not been signed off as reviewed claims.
Why it matters
A study that failed is as informative as one that worked, and both are here.
What we still do not know
No reviewed claim exists, so no exact population, effect size or interval is published yet.
What it changes in the body◇Read from sources, not yet reviewed
The path through the body
From what a person takes to what changes. A solid line is a step measured in people. A dashed line is a step nobody has measured that way.
Start
Tirofiban
What a person takes: Intravenous bolus and infusion from a premixed bag, hospital use only.
The measurement behind this step
Supplied as a 250 mL premixed bag from which the bolus is given over 5 minutes by pump and the maintenance infusion follows immediately, without dilution, for up to 18 hours. Clearance is largely renal and the maintenance rate is halved below a creatinine clearance of 60 mL/min. Onset is within about 10 minutes on the labelled regimen and inhibition reverses over a few hours after the infusion stops.
Getting in
An infusion from a premixed bag, bolus and all
Given straight into a vein from a ready-mixed bag, as a fast loading dose followed by a drip for up to eighteen hours.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Supplied as a 250 mL premixed bag from which both the bolus and the maintenance infusion are drawn without dilution. The labelled regimen is 25 micrograms per kilogram over 5 minutes then 0.15 micrograms per kilogram per minute for up to 18 hours, halved to 0.075 below a creatinine clearance of 60 mL/min because clearance is largely renal.
Fibrinogen attaches to platelets using a specific short chemical handle. This drug is shaped to copy that handle and occupy the socket instead.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
A non-peptide mimic of the arginine-glycine-aspartate (RGD) recognition motif: the piperidine nitrogen substitutes for the arginine guanidine and the carboxylate for the aspartate, held at the right separation by the butyl-ether spacer. This is structure-based drug design in its purest form — the molecule exists to look like three amino acids.
Thrombin, ADP, thromboxane and collagen all switch platelets on by different routes, but all of them end at this one receptor. Blocking it closes every route at once.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Reversible antagonism of fibrinogen binding to glycoprotein IIb/IIIa, the integrin alphaIIb-beta3 heterodimer. Because this is the final common effector of platelet aggregation, inhibition is independent of the activating stimulus — which is why the class produces more complete inhibition than aspirin or a P2Y12 inhibitor, and why it bleeds more.
Platelets can still activate; they just cannot join up
Individual platelets still respond to injury and still stick to the vessel wall. What they cannot do is bridge to each other, so no growing plug forms.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Blocking fibrinogen binding prevents platelet-to-platelet cross-linking without preventing adhesion or granule release. More than 90% inhibition of ex vivo ADP-induced aggregation is reached within 10 minutes on the labelled regimen, and inhibition is reversible on stopping the infusion.
Fewer events for seven days, and no help without heparin
Added to heparin, about a quarter of the bad outcomes in the first week were prevented. Given without heparin, four times as many patients died.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
PRISM-PLUS: composite of death, myocardial infarction or refractory ischaemia 12.9% against 17.9% at seven days with heparin, sustained at 30 days and six months; the tirofiban-alone arm stopped early with seven-day mortality of 4.6% against 1.1%. PRISM: 3.8% against 5.6% at 48 hours, and 15.9% against 17.1% at 30 days — no difference. TARGET: 7.6% against 6.0% on abciximab, hazard ratio 1.26.
No suggested links are held for this record, so nothing is hidden from this path.
What we know
The record describes 5 steps from taking it to an effect in a person.
How we know it
Each step names the study behind it in the technical detail beside it.
What this does not prove
A change inside the body is a reason to look. It is not a result in a person.
Why it matters
A reader can see exactly where the chain stops being measured in people.
What we still do not know
No reviewed claim binds any of these steps to a named population.
What is missing or unclear◇Read from sources, not yet reviewed
Were people like you studied?
RNAWiki cannot tell whether a study fits you. It can show who was in it, and where the result stops carrying.
Who was studied
People similar to this profile were included.
Patients with unstable angina or a non-ST-elevation heart attack, given as an infusion in hospital for up to 18 hours, usually around a coronary procedure. Use of this drug class has fallen substantially since the oral P2Y12 inhibitors arrived.
Who is missing from the studies
Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
What the label states about particular groups
On pediatric, the label states: “Safety and effectiveness in pediatric patients have not been established.”
US prescribing information · fe0ced75-ccbf-4d2e-bd0d-b57e60ab913f · read 2026-08-30
On older people, the label states: “Of the total number of patients in controlled clinical studies of AGGRASTAT, 43% were 65 years and over, while 12% were 75 years and over.”
US prescribing information · fe0ced75-ccbf-4d2e-bd0d-b57e60ab913f · read 2026-08-30
On people who are pregnant, the label states: “Risk Summary While published data cannot definitively establish the absence of risk, available published case reports have not established an association with tirofiban use during pregnancy and major birth defects, miscarriage, or adverse maternal or fetal outcomes.”
US prescribing information · fe0ced75-ccbf-4d2e-bd0d-b57e60ab913f · read 2026-08-30
On people who are breastfeeding, the label states: “Risk Summary There is no data on the presence of tirofiban in human milk, the effects of the drug on the breastfed infant, or the effects of the drug on human milk production.”
US prescribing information · fe0ced75-ccbf-4d2e-bd0d-b57e60ab913f · read 2026-08-30
Where the result stopped carrying
The tirofiban-alone arm of PRISM-PLUS, terminated for excess seven-day mortality
The 30-day composite of PRISM, p=0.34, after a positive 48-hour result
TARGET, a non-inferiority trial that instead demonstrated the superiority of abciximab
The dose used in TARGET, now widely argued to have been too low and superseded on the label by a regimen with no outcome trial of its own
This is a scope explorer, not a diagnosis engine.
It shows who was studied so you can see whether people similar to you were included.
RNAWiki cannot tell whether a study fits you. It can show who was in it.
What it would be like to take◇Read from sources, not yet reviewed
Why it might seem to do nothing
A real effect and a noticed effect are different things. These are the recorded reasons the two come apart.
It was studied in different people
The people in the studies were not much like the reader.
On this record: Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
The evidence may simply be wrong
Small early studies often do not hold up.
On this record: RNAWiki has not yet published a reviewed conclusion for this use.
Other reasons RNAWiki checked and found nothing for (11)
It was studied for a different goal
The studies measured something else entirely. Nothing in this record points to this reason.
A different form was studied
The studied form is not the form on the shelf. Nothing in this record points to this reason.
There was nothing to correct
Where a level is already normal, topping it up may change nothing. Nothing in this record points to this reason.
Something else had to happen too
In the studies it was paired with training, a diet or another treatment. Nothing in this record points to this reason.
The change is too small to feel
A real change can still sit below what a person notices. Nothing in this record points to this reason.
Day-to-day swing hides it
Sleep, food, stress and time of day move most numbers more than this would. Nothing in this record points to this reason.
Not enough time yet
The studies ran longer than the person has waited. Nothing in this record points to this reason.
It was not taken as studied
Missed days change the result, and studies count them. Nothing in this record points to this reason.
Something else changed at the same time
Two changes at once cannot be told apart afterwards. Nothing in this record points to this reason.
The product may not be what it says
Contents of a sold product are not always what the label states. Nothing in this record points to this reason.
No recorded reason
RNAWiki has nothing stored that would explain it. Nothing in this record points to this reason.
None of these is a reason to take more. Taking more is not a step this page ever suggests.
What it would be like to take◇Read from sources, not yet reviewed
What taking it involves
The recorded facts about getting hold of it and using it. Nothing here is a suggestion about what you should do.
How it is supplied
Given by a clinician
❝ Quoted from a source
Where this came from
Copied from a source RNAWiki stored, with the source named.
Read from the recorded approval status.
No source is stored against this line.
Form and route
Intravenous bolus and infusion from a premixed bag, hospital use only
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The form and route recorded on this substance.
No source is stored against this line.
Who oversees it
RNAWiki has not recorded a supervision or regulatory status for this substance.
❝ Quoted from a source
Where this came from
Copied from a source RNAWiki stored, with the source named.
No register row and no identity class settled the question.
No source is stored against this line.
What is in the pack
Supplied as a 250 mL premixed bag from which the bolus is given over 5 minutes by pump and the maintenance infusion follows immediately, without dilution, for up to 18 hours.
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
Recorded notes on how this is sold. The rest of the recorded wording: Clearance is largely renal and the maintenance rate is halved below a creatinine clearance of 60 mL/min. Onset is within about 10 minutes on the labelled regimen and inhibition reverses over a few hours after the infusion stops.
No source is stored against this line.
Where it is registered
Regulatory records are listed in the technical disclosure at the foot of this page.
# Counted from records
Where this came from
A count of rows RNAWiki holds. It describes our records, not your body.
Register entries are stored per jurisdiction and shown with their dates.
No source is stored against this line.
Why people stop
Not recorded.
∅ Nothing recorded
Where this came from
RNAWiki holds nothing here and says so rather than guessing.
No record of why people stopped taking it is stored for this substance.
No source is stored against this line.
What it would be like to take◇Read from sources, not yet reviewed
What can go wrong
Sorted by where each line came from. A regulator's label and a report somebody sent in are not the same kind of fact.
·Worth asking a clinician aboutWritten into the record from the studies named on this page
Bleeding is the most common complication and occurs predominantly at the arterial access site used for catheterisation; concomitant fibrinolytics, anticoagulants and antiplatelet drugs raise it further. Profound thrombocytopenia has been reported: platelet counts are monitored from about six hours after starting and daily thereafter, and a fall below 90,000 per cubic millimetre triggers repeat testing to exclude the EDTA-dependent laboratory artefact before tirofiban and heparin are stopped. Prior exposure to a glycoprotein IIb/IIIa antagonist increases that risk. Clearance is largely renal, so the maintenance rate is reduced in renal impairment.
Nobody counted how many people took this and were fine, so this cannot be turned into a rate.
Over a long time. No completed tested study window is recorded, so long-term effects are not established by the registry record.
Groups the studies covered thinly. Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
What is missing or unclear◇Read from sources, not yet reviewed
Does the exact form matter?
Evidence belongs to the exact thing that was tested. A different salt, a different mixture or a different preparation is a different question.
The form that was studied
Intravenous bolus and infusion from a premixed bag, hospital use only
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The form used in the studies cited on this page.
No source is stored against this line.
What is sold
Clearance is largely renal and the maintenance rate is halved below a creatinine clearance of 60 mL/min. Onset is within about 10 minutes on the labelled regimen and inhibition reverses over a few hours after the infusion stops.
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
Recorded notes on which forms are sold and how they compare.
No source is stored against this line.
What is recorded as being sold
13 products list this as an active ingredient in the United States drug directory. 13 of them contain it and nothing else.
FDA National Drug Code directory · 55150-430 · read 2026-08-29
They are sold as injection, injection, solution and powder, taken intravenous.
FDA National Drug Code directory · 55150-430 · read 2026-08-29
The regulator's established pharmacologic class for it is decreased platelet aggregation [pe] and platelet aggregation inhibitor [epc].
FDA National Drug Code directory · 55150-430 · read 2026-08-29
6 published labels name it as an active ingredient. 6 of them describe this substance alone, which is where its own label text on this page comes from.
US prescribing information · fe0ced75-ccbf-4d2e-bd0d-b57e60ab913f · read 2026-08-29
Those labels are classed as human prescription drug.
US prescribing information · fe0ced75-ccbf-4d2e-bd0d-b57e60ab913f · read 2026-08-29
AGGRASTAT is intravenous at 3 DOSAGE FORMS AND STRENGTHS AGGRASTAT is a clear, non-preserved, colorless, isosmotic, sterile premixed injection with sodium chloride for tonicity adjustment available in the following presentations: Table 1 AGGRASTAT…, recorded as fda label in effect 2025-01-01 in the United States.
US prescribing information · fe0ced75-ccbf-4d2e-bd0d-b57e60ab913f · read 2026-08-30
Evidence carries across two names for one substance. It does not carry across a salt, a mirror form or a mixture.
What it would be like to take◇Read from sources, not yet reviewed
What you could measure
This one is decided with a clinician, so this section holds questions to ask rather than a plan to run.
RNAWiki could not confidently classify this substance, so no self-experiment plan is offered.
Questions worth asking
Which of the trials of Tirofiban studied people like me?
What was measured, and for how long?
Was the result a laboratory value or a health outcome?
What would we watch for, and when would we stop?
Tracking can show whether something changed for you. It cannot show what caused it.
RNAWiki records evidence. It does not say whether this substance is right for you.
What is missing or unclear◇Read from sources, not yet reviewed
Claims that go past the evidence
Things said about this substance that sound reasonable, and the exact step that is missing between the evidence and the claim.
✗Goes past the evidence
That the 48-hour benefit in PRISM carries forward — the 30-day composite showed no difference and death or myocardial infarction at 30 days did not reach significance
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That the labelled 25 microgram per kilogram bolus regimen delivers the trial outcomes — the bridge is equal platelet inhibition reached faster, with no outcome trial of the labelled regimen
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That tirofiban can substitute for anticoagulation — the monotherapy arm was stopped for four times the mortality
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That the stroke result is established — a single-country trial in a heterogeneous population whose own secondary endpoints did not agree with the primary
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
What is missing or unclear◇Read from sources, not yet reviewed
What nobody knows yet
Open questions, each with why it is open and what would close it.
How much did people take in the studies?
The sources RNAWiki checked hold nothing for this field.
Why it matters. A result belongs to an amount. Without the amount the result floats free.
What would answer it
A stored source that records it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing populations
Which groups were under-represented in the studies has not been recorded.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing long-term data
No completed tested study window is recorded.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
No reviewed conclusion
RNAWiki has not yet published a reviewed conclusion for this use.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing interaction studies
No interaction was found in the registers checked. Not finding one is not the same as showing there is none.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Formulation uncertainty
Several salts, forms or products of Tirofiban are recorded. Results from one form may not transfer to another.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Mechanism not reviewed
No reviewed mechanism story exists for this substance.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
What happened in people◇Read from sources, not yet reviewed
Check any of this yourself
Every line above traced back to the study it came from. This is the technical layer, and the vocabulary changes here.
Every line above can be traced to the study named beside it. Follow the link and read it.
PRISM-PLUS: with heparin, the seven-day composite fell from 17.9% to 12.9%
In plain words
Added to heparin and aspirin, tirofiban prevented about a quarter of the deaths, heart attacks and episodes of unrelieved chest pain that heparin alone allowed, and the difference was still there at six months.
What was measured
Composite of death, myocardial infarction or refractory ischaemia at 7, 30 and 180 days, tirofiban plus heparin against heparin alone
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
PRISM-PLUS randomised 1,915 patients with unstable angina or non-Q-wave myocardial infarction, double-blind, to tirofiban alone, heparin alone, or tirofiban plus heparin, with study drug infused for a mean of 71.3 ± 20 hours and angiography after 48 hours where indicated. The composite of death, myocardial infarction or refractory ischaemia within seven days occurred in 12.9% on tirofiban plus heparin against 17.9% on heparin alone — risk ratio 0.68 (95% CI 0.53 to 0.88), p=0.004. The difference persisted at 30 days (18.5% against 22.3%, p=0.03) and at six months (27.7% against 32.1%, p=0.02). Death or myocardial infarction alone was 4.9% against 8.3% at seven days (p=0.006), 8.7% against 11.9% at 30 days (p=0.03), and 12.3% against 15.3% at six months (p=0.06). Major bleeding was 4.0% against 3.0% (p=0.34). This is the trial the indication rests on, and it is a real result with durable follow-up.
Written into the record, not signed off as a reviewed claim
The tirofiban-alone arm was stopped early: 4.6% dead at seven days against 1.1%
In plain words
The same trial had a third arm giving tirofiban without heparin. It was halted because four times as many of those patients died within a week.
What was measured
Seven-day mortality in the tirofiban-monotherapy arm, 4.6% against 1.1% on heparin alone, before the arm was terminated
Effect estimate
No reviewed effect estimate exists for this record.
Limits
This entry records a failure.
From the source
PRISM-PLUS was designed with three arms. The tirofiban-alone arm was stopped prematurely because of excess mortality at seven days: 4.6% against 1.1% for patients treated with heparin alone. The trial then reported the surviving comparison, tirofiban plus heparin against heparin alone, which is the result the indication rests on. Two things follow. First, the drug’s benefit is a property of the combination and not of the molecule on its own, and no reading of this trial supports blocking platelets without anticoagulation in this setting. Second, a fourfold mortality difference large enough to stop an arm is a finding about the drug that appears in the same publication as its licensing result — and it is the kind of finding that a summary of the positive arm alone would silently omit.
Written into the record, not signed off as a reviewed claim
PRISM: the 48-hour benefit was gone at 30 days
In plain words
In 3,232 patients, tirofiban beat heparin during the 48 hours the drip was running. Twenty-eight days later there was no difference between the groups at all.
What was measured
Composite endpoint at 48 hours (3.8% against 5.6%, p=0.01) and at 30 days (15.9% against 17.1%, p=0.34)
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
PRISM randomised 3,232 patients already on aspirin to 48 hours of intravenous tirofiban or heparin. The primary composite of death, myocardial infarction or refractory ischaemia at 48 hours occurred in 3.8% on tirofiban against 5.6% on heparin — risk ratio 0.67 (95% CI 0.48 to 0.92), p=0.01, a 32% relative reduction. At 30 days, with readmission for unstable angina added, the composite was 15.9% against 17.1% (p=0.34): no difference. Death or myocardial infarction at 30 days was 5.8% against 7.1% (risk ratio 0.80, 95% CI 0.61 to 1.05, p=0.11) — also not significant. Mortality alone was 2.3% against 3.6% (p=0.02), which is a single component reaching significance while the composite containing it does not, and should be read as such. Only 1.9% of patients underwent revascularisation during the first 48 hours, so this is a comparison of medical therapy. Reversible thrombocytopenia was more frequent on tirofiban, 1.1% against 0.4% (p=0.04). A treatment effect that exists only while the infusion runs is a real effect and a different claim from prevention of events.
Written into the record, not signed off as a reviewed claim
TARGET: a non-inferiority trial that proved the comparator superior
In plain words
A trial in 4,809 patients set out to show tirofiban was as good as abciximab. It showed the opposite — abciximab was better, and the difference ran the same way for every component.
What was measured
Composite of death, nonfatal myocardial infarction or urgent target-vessel revascularisation at 30 days, 7.6% against 6.0% on abciximab
Effect estimate
No reviewed effect estimate exists for this record.
Limits
This entry records a failure.
From the source
TARGET was a double-blind, double-dummy trial at 149 hospitals in 18 countries, randomising patients undergoing percutaneous coronary revascularisation with intent to stent, and statistically powered to demonstrate non-inferiority of tirofiban against abciximab. The composite of death, nonfatal myocardial infarction or urgent target-vessel revascularisation at 30 days occurred in 7.6% of 2,398 tirofiban patients against 6.0% of 2,411 abciximab patients — hazard ratio 1.26, one-sided 95% upper bound 1.51 demonstrating lack of equivalence, two-sided 95% CI 1.01 to 1.57 demonstrating the superiority of abciximab, p=0.038. Every component moved the same way: death hazard ratio 1.21, myocardial infarction 1.27 (6.9% against 5.4%, p=0.04), urgent revascularisation 1.26. The relative benefit of abciximab held across age, sex, diabetes and clopidogrel pretreatment. Major bleeding and transfusion did not differ; tirofiban caused less minor bleeding and less thrombocytopenia. The published conclusion is unambiguous: tirofiban "offered less protection from major ischemic events than did abciximab". It has been argued since that the tirofiban bolus used in TARGET was too low, which is a plausible explanation and is also the argument that led to the dose change described below.
Written into the record, not signed off as a reviewed claim
The dose on the label today is not the dose either efficacy trial used
In plain words
The two trials that established this drug used a slow 30-minute loading infusion. The regimen printed on the current label is a rapid bolus more than twice as strong, supported by a platelet test rather than by any outcome trial.
What was measured
Time to more than 90% inhibition of ex vivo platelet aggregation: end of the 30-minute infusion on the trial regimen, within 10 minutes on the labelled regimen
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
The United States label states that "two large-scale clinical studies established the efficacy" of tirofiban — PRISM-PLUS and PRISM — and both used a 30-minute loading infusion of 0.4 micrograms per kilogram per minute followed by 0.1 micrograms per kilogram per minute. The recommended dosage section of the same label specifies something different: 25 micrograms per kilogram within 5 minutes, then 0.15 micrograms per kilogram per minute for up to 18 hours, halved to 0.075 below a creatinine clearance of 60 mL/min. The justification appears in the mechanism of action section and is entirely pharmacodynamic: the trial regimen reaches more than 90% inhibition of ex vivo platelet aggregation by the end of the 30-minute infusion, and the recommended regimen reaches the same 90% within 10 minutes. That is a surrogate bridge — equal platelet inhibition, reached sooner, therefore at least equal clinical effect. It is a reasonable bridge and it is an inference, and it means the outcome evidence on this page was generated by a regimen that is no longer the labelled one.
Source
Tirofiban hydrochloride injection, United States prescribing information, sections 2.1, 12.1 and 14
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
contested
Review state
Written into the record, not signed off as a reviewed claim
Profound thrombocytopenia, and a laboratory artefact that mimics it
In plain words
This drug can destroy platelets, sometimes severely, so counts are checked six hours in and daily after. It also causes a false low reading in one type of blood tube, which has to be excluded before treatment is stopped.
What was measured
Reversible thrombocytopenia 1.1% against 0.4% on heparin, with a labelled requirement to exclude pseudothrombocytopenia below 90,000 per cubic millimetre
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
The label requires platelet counts beginning about six hours after starting treatment and daily thereafter, and directs that if the count falls below 90,000 per cubic millimetre, further counts be taken to exclude pseudothrombocytopenia — and that confirmed thrombocytopenia leads to stopping both tirofiban and heparin. Previous exposure to a glycoprotein IIb/IIIa antagonist increases the risk. In PRISM, reversible thrombocytopenia occurred in 1.1% of tirofiban patients against 0.4% on heparin (p=0.04). The pseudothrombocytopenia instruction is not bureaucratic caution: glycoprotein IIb/IIIa inhibitors promote EDTA-dependent platelet clumping in the collection tube, which an automated analyser counts as a catastrophic fall that is not happening in the patient. A drug that produces both a real and an artefactual version of the same laboratory finding is an unusual and instructive measurement problem.
Written into the record, not signed off as a reviewed claim
RESCUE BT2: a positive stroke result whose secondary endpoints did not agree with it
In plain words
A 2023 Chinese trial found more people made an excellent recovery from stroke on tirofiban than on aspirin. The paper itself notes that the other outcomes measured did not point the same way.
What was measured
Modified Rankin scale 0 or 1 at 90 days, 29.1% against 22.2% on aspirin, adjusted risk ratio 1.26 (95% CI 1.04 to 1.53)
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
RESCUE BT2 enrolled 1,177 patients in China with acute ischaemic stroke without occlusion of large or medium-sized vessels, an NIHSS score of 5 or more and at least one moderately to severely weak limb, across four distinct clinical presentations, randomised to two days of intravenous tirofiban or oral aspirin 100 mg, with aspirin for all thereafter to day 90. An excellent outcome — modified Rankin scale 0 or 1 at 90 days — occurred in 29.1% of 606 tirofiban patients against 22.2% of 571 aspirin patients, adjusted risk ratio 1.26 (95% CI 1.04 to 1.53), p=0.02. The publication then records, in its own results section, that "results for secondary end points were generally not consistent with the results of the primary analysis". Mortality was similar. Symptomatic intracranial haemorrhage occurred in 1.0% on tirofiban and 0% on aspirin. Three limits belong on this: the enrolled population was deliberately heterogeneous, spanning four different clinical situations; the trial was conducted entirely in China and registered on the Chinese Clinical Trial Registry; and a primary endpoint at p=0.02 whose secondary endpoints disagree is a result awaiting replication rather than a settled one.
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Felt, measured, or meaningful — found nothing in the sources checked.
How long anything takes — found nothing in the sources checked.
What it may clash with — found nothing in the sources checked.
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The record as stored
The full record, for auditing
Everything above is built from what is below. This layer keeps the technical vocabulary, record identifiers and every stored row, so a reader who wants to check the page can.
The older medicine-wide conclusion held in this record
Written for a clinical reader, and about the medicine as a whole rather than about one indication, population and set of trials. RNAWiki does not treat it as a programme conclusion and no reviewer has signed it off in that form. It is here word for word because it is what the record holds.
A reversible blocker of the final receptor in platelet clumping, whose combination arm cut death, infarction or refractory ischaemia from 17.9% to 12.9% at seven days — while the arm given without heparin was stopped early for a mortality of 4.6% against 1.1%, its 48-hour benefit in a second trial had disappeared by 30 days, and the dose printed on the label today is not the dose either of those trials used.
Recorded evidence blocks (8)
Q1
On the Tirofiban label: indicated for what?
"Tirofiban Hydrochloride Injection is indicated to reduce the rate of thrombotic cardiovascular events (combined endpoint of death, myocardial infarction, or refractory ischemia/repeat cardiac procedure) in patients with non-ST elevation acute coronary syndrome (NSTE-ACS). Tirofiban Hydrochloride Injection is a…": indications and usage on Tirofiban's label. DailyMed label · 7731e46a-2121-441b-b090-12dcefe240f0 · 2025-02-12
Q2
56 registered trials of Tirofiban — at which phases?
2 hours; Tirofiban hydrochloride has a half-life of approximately 2 hours.
metabolismpharmacokinetics
Metabolism appears to be limited.
recorded 2025-02-12 · last checked 2026-09-04
Q5
Which 15 trials of Tirofiban posted no result?
Posted no result
15 of 15 completed trials
Registrations
NCT00790387, NCT00611169, NCT00383136, NCT00538317, NCT00566891 and NCT01109134, and 9 more
Completion dates
oldest 2006-12; newest 2023-10-15
Show the evidence
Trial
NCT00790387
2006-12
NCT00611169
2007-08
NCT00383136
2007-09
NCT00538317
2008-11
NCT00566891
2009-02
NCT01109134
2009-08
9 further recorded trials
NCT00398463
2011-05
NCT01336348
2012-06
NCT01766154
2013-03
NCT02054000
2013-12
NCT01498003
2014-06
NCT02131220
2017-09
NCT02978040
2019-12-27
NCT04368377
2020-04-23
NCT04851457
2023-10-15
Q6
At the median, Tirofiban's trials enrolled 301 people — anything larger?
Median enrolment
301
Largest enrolment
20000
Registered trials counted
56
Q7
What do 1297 spontaneous reports say about Tirofiban — and not say?
These are reports people sent to a regulator. They do not show the medicine caused the reaction. Nobody counted how many people took the medicine and reported nothing. The same event can be reported more than once, and many reports are incomplete. News coverage, lawsuits and new warnings change how often people report. A count is not a rate and not a risk.
Tirofiban appears in spontaneous reports to regulators. Across the 10 most-reported reaction terms, 1297 reaction mentions were counted: haemorrhage 357; thrombocytopenia 214; haemorrhage intracranial 169; myocardial infarction 168. FAERS via Open Targets · CHEMBL3189072 · 2026-06-24
Show the evidence
haemorrhage
357
thrombocytopenia
214
haemorrhage intracranial
169
myocardial infarction
168
angina pectoris
129
cerebral haemorrhage
86
4 more recorded rows
cardiac failure
62
vascular stent thrombosis
58
arrhythmia
28
gastrointestinal haemorrhage
26
recorded 2026-06-24 · last checked 2026-09-04
Q8
Which 10 reactions does Tirofiban's label not list?
ChEMBL 37 — CC BY-SA 3.0 Unported · ClinicalTrials.gov — US Government work · Open Targets 26.06 — CC0 · mixed register set; per-register licences in docs/specs/corpus-20k-sources.md · openFDA / DailyMed — US Government work
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