Formulary
Bivalirudin: Indications, Dosing, Side Effects and Interactions
Bivalirudin, a hirudin analogue, is a thrombin inhibitor.
MedNext Academy | 3 min read
Bivalirudin: Indications, Dosing, Side Effects and Interactions
Bivalirudin, a hirudin analogue, is a thrombin inhibitor.
Drug action
Bivalirudin, a hirudin analogue, is a thrombin inhibitor.
Cautions
Brachytherapy procedures; previous exposure to lepirudin (theoretical risk from lepirudin antibodies)
Contraindications
Bleeding (active); bleeding disorders; hypertension (severe); subacute bacterial endocarditis
Side effects
Common or very common Procedural complications; skin reactions Uncommon Anaemia; headache; hypersensitivity; hypotension; nausea; shock; thrombocytopenia Rare or very rare Arrhythmias; cardiac tamponade; chest pain; compartment syndrome; dyspnoea; embolism and thrombosis; intracranial haemorrhage; pain; vascular disorders; vomiting
Interactions
**Other interactions (3):**
- Interaction studies have been conducted with platelet inhibitors, including acetylsalicylic acid, ticlopidine, clopidogrel, abciximab, eptifibatide, or tirofiban.
- From the knowledge of their mechanism of action, combined use of anti-coagulant medicinal products (heparin, warfarin, thrombolytics or antiplatelet agents) can be expected to increase the risk of...
- In any case, when bivalirudin is combined with a platelet inhibitor or an anticoagulant, clinical and biological parameters of haemostasis should be regularly monitored.
Pregnancy
Manufacturer advises avoid unless potential benefit outweighs risk-no information available.
Breast feeding
Manufacturer advises caution-no information available.
Renal impairment
Avoid if eGFR less than 30 mL/minute/1.73 m 2 . M Dose adjustments When used for Percutaneous coronary intervention: Use initial dose then reduce rate of infusion to 1.4 mg/kg/hour if eGFR 30-60 mL/minute/1.73 m 2 -monitor blood clotting parameters. M See Prescribing in renal impairment .
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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