{"id":1645,"date":"2023-06-25T17:29:04","date_gmt":"2023-06-25T17:29:04","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/argatroban\/"},"modified":"2023-06-25T19:53:47","modified_gmt":"2023-06-25T19:53:47","slug":"argatroban","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/argatroban\/","title":{"rendered":"Argatroban"},"content":{"rendered":"

<\/p>\n

Argatroban<\/h1>\n

CLINICAL USE<\/h3>\n

Anticoagulant:<\/p>\n

  • Prophylaxis or treatment of thrombosisin patients with heparin-induced
    \nthrombocytopenia (HIT)<\/li>\n
  • Adjunct in patients at risk of HITundergoing percutaneous coronary
    \nintervention<\/p>\n

    DOSE IN NORMAL RENAL FUNCTION<\/h3>\n<\/li>\n
  • Anticoagulant for prophylaxis ortreatment of thrombosis: infusion of
    \n2 mcg\/kg\/min; adjust according to
    \nresponse (APTT); maximum
    \n10 mcg\/kg\/min<\/li>\n
  • Anticoagulant for patients undergoingpercutaneous coronary intervention:
    \ninitially a bolus of 350 mcg\/kg
    \nadministered via a large bore IV line over
    \n3\u20135 minutes, followed by an infusion of
    \n25 mcg\/kg\/min. Additional IV bolus doses
    \nof 150 mcg\/kg may be given if required and
    \nthe infusion rate changed to
    \n15\u201340 mcg\/kg\/min<\/p>\n

    PHARMACOKINETICS<\/h3>\n<\/li>\n
  • Molecular weight                           :
    \n508.6<\/li>\n
  • %Protein binding                           :
    \n54<\/li>\n
  • %Excreted unchanged in urine     :
    \n16<\/li>\n
  • Volume of distribution (L\/kg)       :
    \n0.17<\/li>\n
  • half-life \u2013 normal\/ESRD (hrs)      :
    \n39\u201351 minutes\/
    \nUnchanged<\/p>\n

    DOSE IN RENAL IMPAIRMENT<\/h3>\n

    GFR (mL\/MIN)<\/h4>\n<\/li>\n
  • 20 to 50     : Dose as in normal renal function<\/li>\n
  • 10 to 20     : Dose as in normal renal function<\/li>\n
  • <10           :
    \nDose as in normal renal function<\/p>\n

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES<\/h3>\n<\/li>\n
  • CAPD                :
    \nUnlikely to be dialysed. Dose as in
    \nnormal renal function<\/li>\n
  • HD                     :
    \nNot dialysed. Dose as in normal renal function<\/li>\n
  • HDF\/high flux   :
    \nNot dialysed. Dose as in normal renal function<\/li>\n
  • CAV\/VVHD      :
    \nUnlikely to be dialysed. Dose as in
    \nnormal renal function<\/p>\n

    IMPORTANT DRUG INTERACTIONS<\/h3>\n

    Potentially hazardous interactions with other drugs<\/li>\n

  • Heparin: avoid concomitantadministration<\/li>\n
  • Urokinase: may increase the risk ofbleeding<\/li>\n
  • Thrombolytics: may increase risk ofbleeding complications; enhance effect of
    \nargatroban<\/li>\n
  • Antiplatelets and anticoagulants: increasedrisk of bleeding complications
    \n

    ADMINISTRATION<\/h3>\n

    Reconstition<\/h4>\n

    \u2013<\/p>\n

    Route<\/h4>\n

    IV<\/p>\n

    Rate of Administration<\/h4>\n

    Bolus: over 3\u20135 minutes<\/p>\n

    Infusion: 2\u201325 mcg\/kg\/min<\/p>\n

    Comments<\/h4>\n<\/li>\n
  • Physically and chemically stable for up to96 hours if refrigerated or at controlled
    \nroom temperature and protected from
    \nlight<\/li>\n
  • Dilute to 1 mg\/mL with sodium chloride0.9%, glucose 5% or Lactated Ringer\u2019s
    \nsolution, i.e. 250 mg (2.5 mL) into 250 mL
    \nof diluent. The solution must be mixed by
    \ninversion for 1 minute<\/p>\n

    OTHER INFORMATION<\/h4>\n<\/li>\n
  • Can also be used for haemodialysisanticoagulation: 0.1 mg\/kg bolus, followed
    \nby a continuous infusion of 0.1-0.2 mg\/kg\/
    \nhour, dosing being adjusted to maintain an
    \nAPTT 1.5\u20133 times normal.<\/li>\n
  • For CVVHD a dose of 0.5\u20131 mcg\/kg\/minwas suggested, dosing being adjusted to
    \nmaintain an APTT 1.5\u20132 times normal.<\/li>\n
  • 20% of argatroban is removed during a4 hour dialysis session<\/li>\n
  • There is no specific antidote<\/li>\n
  • Contraindicated in patients with overtmajor bleeding<\/li>\n","protected":false},"excerpt":{"rendered":"

    Argatroban CLINICAL USE Anticoagulant: Prophylaxis or treatment of thrombosisin patients<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-1645","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1645","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=1645"}],"version-history":[{"count":1,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1645\/revisions"}],"predecessor-version":[{"id":2904,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1645\/revisions\/2904"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=1645"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=1645"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=1645"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}