Bivalirudin

Indications
 Intravenous
As an anticoagulant in percutaneous coronary intervention
Adult: 750 mcg/kg by intravenous inj followed by an infusion of 1.75 mg/kg/hr during procedure and up to 4 hours postprocedure. If needed, may continue infusion at 0.2 mg/kg/hr for up to 20 hours.
CrCl (ml/min)Dosage Recommendation
30-59Reduce dose by 20%.
<30Contraindicated.
DialysisContraindicated.
Contraindications
 Active major bleeding. CrCl <30 ml/min and dialysis-dependent patients.
Warnings / Precautions
 Patients at risk of serious bleeding, recent major surgery or puncture of large vessels or organ biopsy. Hepatic or renal impairment.
Adverse Reactions
 Bleeding, hypersensitivity reactions. Hypertension, hypotension, bradycardia, nausea, vomiting, dyspepsia, urinary retention, back pain, headache, injection site pain & anxiety.
Potentially Fatal: Severe anaphylactic reactions which may lead to death. (See lit)
Drug Interactions
 May increase risk of bleeding when used with thrombolytics, oral anticoagulants or drugs that affect platelet function.
See Below for More bivalirudin Drug Interactions
Mechanism of Actions
 Bivalirudin is an analogue of the peptide hirudin. It is a specific and reversible direct thrombin inhibitor thats works by binding to the catalytic and anionic exosite of circulating and clot-bound thrombin. It is used as an anticoagulant in percutaneous coronary intervention.
Distribution: Does not bind to plasma proteins.
Metabolism: Partly metabolised by the kidneys.
Excretion: Partially cleared renally and proteolytic cleavage. Elimination half-life (normal renal function): 25 minutes.
Storage Conditions
 Intravenous: Store unopened vials at 15-30°C. Store reconstituted vials at 2-8°C.
ATC Classification
 B01AE06 - bivalirudin ; Belongs to the class of direct thrombin inhibitors. Used in the treatment of thrombosis.
Storage
 Intravenous: Store unopened vials at 15-30°C. Store reconstituted vials at 2-8°C.
Available As
  • Bivalirudin 250 mg

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