Generic Name and Formulations:
Bivalirudin 250mg/vial; pwd for IV inj after reconstitution and dilution.
The Medicines Company
Anticoagulation with concomitant aspirin in: unstable angina undergoing percutaneous transluminal coronary angioplasty (PTCA); patients with, or at risk of, heparin–induced thrombocytopenia (HIT) and thrombosis syndrome (HITTS) undergoing percutaneous coronary intervention (PCI), and in patients undergoing PCI with provisional use of glycoprotein IIb/IIIa (GPI).
Give with aspirin 300–325mg daily: initiate 0.75mg/kg IV bolus (may give additional bolus of 0.3mg/kg after 5mins, if needed in those without HIT/HITTS), followed by 1.75mg/kg/hr for duration of procedure. May continue infusion up to 4hrs post-procedure; after 4hrs, may give additional infusion of 0.2mg/kg/hr up to 20hrs, if needed. Renal impairment: CrCl <30mL/min: reduce infusion rate to 1mg/kg/hr; hemodialysis: 0.25mg/kg/hr.
Active major bleeding.
Consider stopping if symptoms of bleeding occur. Increased risk of thrombus formation with brachytherapy. Diseases associated with an increased bleeding risk. Monitor for acute stent thrombosis and signs/symptoms of MI in STEMI patients following PCI. Renal impairment. Pregnancy (Cat.B). Nursing mothers.
Increased bleeding risk with warfarin, heparin, thrombolytics. Interferes with INR measurements.
Bleeding, back pain, pain, headache, GI upset, hypo- or hypertension, inj site pain, urinary retention.
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