Comparative Pharmacology
Head-to-head clinical analysis: ARGATROBAN versus BIVALIRUDIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ARGATROBAN versus BIVALIRUDIN.
ARGATROBAN vs BIVALIRUDIN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Direct thrombin inhibitor that reversibly binds to the active site of thrombin, inhibiting fibrin formation, activation of coagulation factors V, VIII, XIII, 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 dose: 2 mcg/kg/min IV continuous infusion; adjust to maintain aPTT 1.5-3 times baseline. For patients with HIT undergoing PCI: initial bolus 350 mcg/kg IV, then 25 mcg/kg/min IV infusion.
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.
MODERATE Risk
MODERATE Risk
Clinical Note
moderateArgatroban + Benzydamine
"Argatroban may increase the anticoagulant activities of Benzydamine."
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
moderateArgatroban + Estrone sulfate
Terminal half-life 39-51 minutes (dose-dependent); clinical context: continuous IV infusion required for stable anticoagulation.
25 minutes (in patients with normal renal function); prolonged to ~57 minutes in severe renal impairment (CrCl <30 mL/min).
Primarily hepatic (CYP450) metabolism; fecal (~65% as unchanged and metabolites) and renal (~22% with ~16% unchanged) elimination.
Renal: 20% unchanged; proteolytic cleavage (hepatic and other sites) accounts for the remainder.
Category C
Category C
Direct Thrombin Inhibitor
Direct Thrombin Inhibitor
"The serum concentration of Estrone sulfate can be decreased when it is combined with Argatroban."