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BLOOD AND BLOOD FORMING ORGANS › ANTITHROMBOTIC AGENTS › ANTITHROMBOTIC AGENTS › Direct thrombin inhibitors
bivalirudin
B01AE06
Forms & Strengths
- Injectable powder for reconstitution: 250 mg per vial
Adult Dosing
- Percutaneous Coronary Intervention (PCI): 0.75 mg/kg IV bolus, then 1.75 mg/kg/h infusion for the duration of the procedure
- PCI with heparin-induced thrombocytopenia (HIT): 0.75 mg/kg IV bolus, then 1.75 mg/kg/h infusion
- Anticoagulation in patients with unstable angina undergoing PCI: 0.75 mg/kg bolus followed by 1.75 mg/kg/h infusion
Pediatric Dosing
- Safety and efficacy in pediatric patients have not been established
Indications
- Anticoagulant in patients with unstable angina undergoing percutaneous transluminal coronary angioplasty (PTCA)
- Anticoagulant in patients undergoing percutaneous coronary intervention (PCI) with provisional use of glycoprotein IIb/IIIa inhibitor
- Patients with or at risk of heparin-induced thrombocytopenia (HIT) undergoing PCI
Mechanism of Action
- Direct thrombin inhibitor that specifically binds to both the catalytic site and anion-binding exosite of free and clot-bound thrombin
- Prevents thrombin-mediated conversion of fibrinogen into fibrin and activation of factors V, VIII, and XIII
Contraindications
- Active major bleeding
- Hypersensitivity to bivalirudin or its components
Adverse Reactions
- Major and minor bleeding complications
- Nausea, vomiting, and headache
- Back pain
- Hypotension and bradycardia
- Pain at the injection site
Drug Interactions
- Anticoagulants, antiplatelet agents, and thrombolytics increase the risk of hemorrhage
- Glycoprotein IIb/IIIa inhibitors may increase bleeding risk when co-administered
Curated Content: Needs Vetting Before Put to Clinical Use