Bivalirudin Dosage
This dosage information may not include all the information needed to use Bivalirudin safely and effectively. See additional information for Bivalirudin.
The information at Drugs.com is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist.
Usual Adult Dose for:
Additional dosage information:
Usual Adult Dose for Angina Pectoris
Initial: 0.75 mg/kg administered as an intravenous bolus dose, followed by 1.75 mg/kg/hour for the duration of the PCI procedure.
Five minutes after the bolus dose, an ACT should be performed and an additional bolus of 0.3 mg/kg should be given if needed. Administration of a glycoprotein IIb/IIIa inhibitor should be considered in the event that any of the following conditions are present: decreased TIMI flow (0 to 2) or slow reflow; dissection with decreased flow; new or suspected thrombus; persistent residual stenosis; distal embolization; unplanned stent; suboptimal stenting; side branch closure; abrupt closure; clinical instability; and prolonged ischemia.
The recommended dose of bivalirudin in patients with HIT/HITTS undergoing PCI is an IV bolus dose of 0.75 mg/kg, followed by a continuous infusion at a rate of 1.75 mg/kg/hour for the duration of the procedure.
Continuation of the infusion for up to 4 hours post procedure is optional. After 4 hours, an additional IV infusion may be initiated at a rate of 0.2 mg/kg/hour for up to 20 hours if needed.
Bivalirudin is intended for use with aspirin (300 mg to 325 mg daily), and has been studied only in patients receiving concomitant aspirin.
Usual Adult Dose for Percutaneous Coronary Intervention
Initial: 0.75 mg/kg administered as an intravenous bolus dose, followed by 1.75 mg/kg/hour for the duration of the PCI procedure.
Five minutes after the bolus dose, an ACT should be performed and an additional bolus of 0.3 mg/kg should be given if needed. Administration of a glycoprotein IIb/IIIa inhibitor should be considered in the event that any of the following conditions are present: decreased TIMI flow (0 to 2) or slow reflow; dissection with decreased flow; new or suspected thrombus; persistent residual stenosis; distal embolization; unplanned stent; suboptimal stenting; side branch closure; abrupt closure; clinical instability; and prolonged ischemia.
The recommended dose of bivalirudin in patients with HIT/HITTS undergoing PCI is an IV bolus dose of 0.75 mg/kg, followed by a continuous infusion at a rate of 1.75 mg/kg/hour for the duration of the procedure.
Continuation of the infusion for up to 4 hours post procedure is optional. After 4 hours, an additional IV infusion may be initiated at a rate of 0.2 mg/kg/hour for up to 20 hours if needed.
Bivalirudin is intended for use with aspirin (300 mg to 325 mg daily), and has been studied only in patients receiving concomitant aspirin.
Renal Dose Adjustments
No reduction in the bolus dose is recommended; however, the infusion dose of bivalirudin may need to be reduced in patients with renal dysfunction. The manufacturer recommends the following dosage adjustments:
Clcr less than 30 mL/min: reduce to 1.0 mg/kg/hour
Hemodialysis: reduce to 0.25 mg/kg/hour
Liver Dose Adjustments
Data not available
Precautions
Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).
Dialysis
Approximately 25% of a dose of bivalirudin is removed by hemodialysis. Patients undergoing hemodialysis should receive a reduced infusion dose of 0.25 mg/kg/hour (a reduction in the bolus dose is not necessary).
Other Comments
Bivalirudin is intended for use with aspirin and has been studied only is patients receiving concomitant aspirin.
