Comparative Pharmacology
Head-to-head clinical analysis: BIVALIRUDIN versus DABIGATRAN ETEXILATE MESYLATE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: BIVALIRUDIN versus DABIGATRAN ETEXILATE MESYLATE.
BIVALIRUDIN vs DABIGATRAN ETEXILATE MESYLATE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
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.
Direct thrombin inhibitor that reversibly binds to the active site of thrombin, preventing fibrinogen cleavage and clot formation.
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.
150 mg orally twice daily
None Documented
None Documented
25 minutes (in patients with normal renal function); prolonged to ~57 minutes in severe renal impairment (CrCl <30 mL/min).
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: 12–17 hours (mean ~14 hours) in healthy adults; prolonged to 15–34 hours in moderate renal impairment (CrCl 30–50 mL/min); no significant change in mild hepatic impairment. Clinical context: Supports twice-daily dosing; accumulation risk in renal impairment.
Renal: 20% unchanged; proteolytic cleavage (hepatic and other sites) accounts for the remainder.
Renal: 80% unchanged drug via glomerular filtration and tubular secretion; Fecal: ~6% via biliary secretion; Hepatic metabolism (minor) via esterase-mediated hydrolysis to glucuronide conjugates (less than 5% of dose).
Category C
Category C
Direct Thrombin Inhibitor
Direct Thrombin Inhibitor
"Bivalirudin may increase the anticoagulant activities of Droxicam."