Bivalirudin

Details About Generic Salt ::  Bivalirudin 

Main Medicine Class:: Hematological System   Sub Medicine Class ::  Anti Coagulants

5B. ANTI-COAGULANTS in 5. HEMATOLOGICAL SYSTEM
BIVALIRUDIN
THROMBIN INHIBITOR | ANTI-COAGULANT
PK: D: 0.2 L/kg M: Blood protease, kidney E: Urine

Indications & Dose: ACUTE CORONARY SYNDROME IV Adult Initially 100µg/kg followed by inf of 250µg/kg/h upto 72h. In patients undergoing PCI/CABG without cardiopulmonary bypass, further dose of 500µg/kg is given with increased inf (1.75mg/kg/h). After PCI, administer 250µg/kg/h for next 4-12h if required. Patients undergoing CABG with cardiopulmonary bypass, stop inf 1h before the procedure & patient should be treated with unfractionated heparin | PERCUTANEOUS CORONARY INTERVENTION/REVASCULARIZATION PROCEDURES IV Adult Initially 0.75mg/kg bolus immediately prior to procedure followed by 1.75mg/kg/h for duration of procedure & up to 4h post procedure if needed. Measure ACT 5 min after bolus dose, additional bolus dose (0.3mg/kg) may be given if required

Contra: hypersensitivity, active major bleeding

Precautions: unstable angina, renal impairment, bacterial endocarditis, congenital/acquired bleeding disorders, HTN, CVA, intracerebral surgery, organ biopsy, anticoagulants

ADR: Serious: bleeding, hemorrhage, hypotension, angina, bradycardia, cerebral ischemia, syncope, thrombocytopenia, renal failure, pulmonary edema, ventricular fibrillation, Others: insomnia, anxiety, fever, nervousness, abdominal pain, dyspepsia, urinary retention, pelvic pain

DDI: Serious Prasugrel/Heparin/Thrombolytics/Warfarin increases risks of bleeding

Monitor: ACT,PTT

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