{"id":3749,"date":"2025-03-31T18:11:48","date_gmt":"2025-03-31T18:11:48","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/bivalirudin-txt\/"},"modified":"2025-03-31T18:11:48","modified_gmt":"2025-03-31T18:11:48","slug":"bivalirudin-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/bivalirudin-txt\/","title":{"rendered":"Bivalirudin.txt"},"content":{"rendered":"

Bivalirudin<\/h1>\n

CLINICAL USE <\/H3>
\nAnticoagulant:<\/p>\n
  • Percutaneous coronary intervention

    DOSE IN NORMAL RENAL FUNCTION <\/H3>Initially bolus of 750 mcg\/kg then an infusion of 1.75 mg\/kg\/hour

    PHARMACOKINETICS <\/H3>
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :2180.3<\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :0<\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp : 20<\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp :0.1<\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp :13\u201337 minutes\/ 57 minutes (310 minutes in dialysis patients on non-<\/p>\n
  • HD days)

    DOSE IN RENAL IMPAIRMENT <\/H3>

    GFR (mL\/MIN)<\/H4>30\u201350 Dose as in normal renal function10\u201330 Normal bolus dose. Reduce infusion dose by 20% (1.4 mg\/kg\/hour). See \u2018Other Information\u2019
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Normal bolus dose. Reduce infusion dose by 80% and monitor ACT. See \u2018Other Information\u2019

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Unknown dialysability. Dose as for GFR <10 mL\/min\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Dialysed. Dose as for GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL\/min
  • HDF\/high flux &nbsp :Dialysed. Dose as for GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL\/min
  • CAV\/VVHD &nbsp &nbsp &nbsp:Unknown dialysability. Dose as for GFR=10\u201329 mL\/min

    IMPORTANT DRUG INTERACTIONS <\/H3>Potentially hazardous interactions with other drugs\n
  • Antiplatelets and anticoagulants: increased risk of bleeding\n
  • Thrombolytics: may increase risk of bleeding complications; enhance effect of bivalirudin

    ADMINISTRATION <\/H3>

    Reconstition<\/H4>Reconstitute each 250 mg vial with 5 mL water for injection

    Route <\/H4>IV

    Rate of Administration <\/H4>1.75 mg\/kg\/hour

    Comments<\/H4>Further dilute with 50 mL sodium chloride 0.9% or glucose 5% if for infusion\n
  • Stable for 24 hours at room temperature

    OTHER INFORMATION <\/H4>\n
  • Monitor ACT in renal impairment\n
  • Can start bivalirudin 30 minutes after stopping unfractionated heparin and 8 hours after stopping LMWHNo known antidote Dose recommendations vary from country to country; doses above are from New Zealand\n
  • UK doses: GFR=30\u201359 mL\/min: reduce dose by \u201420%GFR<30 mL\/min: contraindicated \u2014USA doses: Normal dose: 1 mg\/kg bolus then \u20142.5 mg\/kg infusionGFR=30\u201359 mL\/min: reduce dose by \u201420%GFR=10\u201329 mL\/min: reduce dose by \u201460%Dialysis dependent: reduce dose by \u201490%\n
  • Lobo BL. Use of newer anticoagulants in patients with chronic kidney disease. Am J Health-Syst Pharm. 2007, Oct 1; 64: 2017\u201326:\n
  • GFR=30\u201350 mL\/min: 1.75 mg\/kg\/hour \u2014\n
  • GFR<30 mL\/min: 1 mg\/kg\/hour \u2014\n
  • On haemodialysis: 0.25 mg\/kg\/hour
    \n","protected":false},"excerpt":{"rendered":"

    Bivalirudin CLINICAL USE Anticoagulant: Percutaneous coronary intervention DOSE IN NORMAL<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-3749","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\/3749","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=3749"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/3749\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=3749"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=3749"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=3749"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}