Abciximab (c7E3 Fab) is an inhibitor of platelet glycoprotein IIb/IIIa. Occasionally an infusion of Abxicimab may be followed by significant thrombocytopenia. Berkowitz et al developed an algorithm to manage these patients.



(1) baseline platelet count

(2) platelet count 2 to 4 hours after a bolus dose of Abciximab, while an infusion of the drug is running

(3) platelet count 12 to 24 hours after the Abciximab infusion


Criteria for drug-induced thrombocytopenia - one or both of the following:

(1) a post-dose platelet count < 100,000 per µL

(2) a decrease in the platelet count by > 40% from the baseline count



(1) Exclude pseudothrombocytopenia.

(2) Exclude other causes of thrombocytopenia, especially heparin-induced thrombocytopenia and infection.

(3) Discontinue the Abciximab if still being infused.

(4) Administer platelets if the platelet count is < 20,000 per µL or at higher platelet counts if bleeding is a problem.

(5) Discontinue other drugs that may be contributing to the thrombocytopenia. Aspirin or ticlopidine may be continue if needed.

(6) Avoid things that may cause bleeding (no intramuscular injections, maintain bedrest, etc.)

(7) Monitor the platelet count every 12 hours until rebound confirmed. If the thrombocytopenia lasts more than 2 days consider another cause for the thrombocytopenia.


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