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Bivalirudin Solution for injection

It is used in a hospital setting to help prevent blood clots

Generic Name: bivalirudin

Brand Names: Angiomax

There is an FDA Alert for this drug. Click here to view it.

Special Alerts:

The Editors of AHFS Drug Information® (AHFS DI®) and AHFS DI Essentials® wish to inform you of an error in the monographs for bivalirudin 20:12.04.12 that resulted from an error in one of the cited references, the American College of Chest Physicians (ACCP) guideline on treatment and prevention of heparin-induced thrombocytopenia (Warkentin TE, Greinacher A, Koster A et al. Treatment and prevention of heparin-induced thrombocytopenia: American College of Chest Physicians evidence-based clinical practice guidelines (8th ed). Chest. 2008; 133 (Suppl):340S-80S).

The error appears under the subhead Heparin-induced Thrombocytopenia in Patients Undergoing Cardiac Surgery, in Dosage and Administration. In the second sentence under this subhead, the statement should read:

“During cardiopulmonary bypass, initially, 1 mg/kg by direct IV injection followed by 2.5 mg/kg per hour by continuous IV infusion has been used; if needed, additional direct IV doses of 0.1–0.5 mg/kg have been given to maintain a 2.5-fold or greater prolongation of the baseline ACT.”

The originally stated dosage of 0.1–0.5 mg for additional direct IV doses of bivalirudin is incorrect.

The following reflects the corrected version of this information, incorporating the change noted above.

What is this medicine?

BIVALIRUDIN is an anticoagulant. It is used in a hospital setting to help prevent blood clots.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
  • bleeding disorders or hemophilia
  • weak or unstable blood vessels
  • an unusual or allergic reaction to bivalirudin, other medicines, foods, dyes, or preservatives
  • pregnant or trying to get pregnant
  • breast-feeding

How should I use this medicine?

This medicine is for injection under the skin or for infusion into a vein. It is given by a health care professional in a hospital or clinic setting.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

What if I miss a dose?

This does not apply.

What may interact with this medicine?

Do not take this medicine with any of the following medications:
  • agents that dissolve blood clots, like heparin
  • blood thinners such as warfarin
  • mifepristone

This medicine may also interact with the following medications:

  • abciximab
  • cilostazol
  • clopidogrel
  • dipyridamole
  • eptifibatide
  • lamifiban
  • NSAIDs like ibuprofen
  • ticlopidine
  • tirofiban

What should I watch for while using this medicine?

Your condition will be monitored carefully while you are receiving this medicine.

Monitor your skin closely for easy bruising or red spots. Tell your doctor or health care professional if you notice any unusual bruising or bleeding.

Be careful to avoid injury while you are receiving this medicine. Take special care brushing or flossing your teeth. Report any injuries to your doctor or health care professional.

If you are going to have surgery, tell your doctor or health care professional that you have received this medicine.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:
  • allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
  • back or stomach pain
  • black, tarry stools
  • blood in urine
  • coughing up blood
  • difficulty breathing or tightness in chest
  • dizziness or fainting spells
  • heavy menstrual bleeding
  • nosebleeds
  • unusual bruising or bleeding at any site

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

  • irritation at the injection site

Where should I keep my medicine?

This drug is given in a hospital or clinic and will not be stored at home.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Last Updated: March 19, 2009
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