Comparative Pharmacology
Head-to-head clinical analysis: ARGATROBAN IN DEXTROSE versus BIVALIRUDIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ARGATROBAN IN DEXTROSE versus BIVALIRUDIN.
ARGATROBAN IN DEXTROSE vs BIVALIRUDIN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Argatroban is a direct thrombin inhibitor that binds reversibly to the active site of thrombin, inhibiting fibrin formation, activation of coagulation factors V, VIII, XIII, and protein C, and platelet aggregation.
Bivalirudin is a direct thrombin inhibitor that binds reversibly to the active site of both free and clot-bound thrombin, inhibiting thrombin-mediated conversion of fibrinogen to fibrin and activation of factors V, VIII, and XIII.
Initial bolus of 350 mcg/kg IV over 3-5 minutes, followed by continuous IV infusion at 25 mcg/kg/min for normal coagulation; titrate to aPTT 1.5-3 times baseline, not exceeding 100 seconds; typical infusion rate 2-10 mcg/kg/min.
Initial intravenous bolus of 0.75 mg/kg, followed by continuous intravenous infusion at 1.75 mg/kg/hour for the duration of the procedure.
None Documented
None Documented
Clinical Note
moderateBivalirudin + Benzydamine
"Bivalirudin may increase the anticoagulant activities of Benzydamine."
Clinical Note
moderateBivalirudin + Deferasirox
"The risk or severity of adverse effects can be increased when Bivalirudin is combined with Deferasirox."
Clinical Note
moderateBivalirudin + Estrone sulfate
"The serum concentration of Estrone sulfate can be decreased when it is combined with Bivalirudin."
Clinical Note
moderateBivalirudin + Droxicam
Terminal elimination half-life is 39–51 minutes in healthy subjects; prolonged in hepatic impairment (up to 3.1 hours). Clinically, it corrects within 2–4 hours after infusion cessation.
25 minutes (in patients with normal renal function); prolonged to ~57 minutes in severe renal impairment (CrCl <30 mL/min).
Primarily hepatobiliary (fecal excretion) ~65% as unchanged drug and metabolites; renal excretion ~22% (12% unchanged, 10% as metabolites). Minimal biliary excretion of unchanged drug.
Renal: 20% unchanged; proteolytic cleavage (hepatic and other sites) accounts for the remainder.
Category C
Category C
Direct Thrombin Inhibitor
Direct Thrombin Inhibitor
"Bivalirudin may increase the anticoagulant activities of Droxicam."