Bivalirudin Dosage
Medically reviewed by Drugs.com. Last updated on Mar 20, 2025.
Applies to the following strengths: 250 mg; 250 mg/50 mL
Usual Adult Dose for:
Additional dosage information:
Usual Adult Dose for Angina Pectoris
For patients who do not have heparin-induced thrombocytopenia (HIT) or heparin-induced thrombocytopenia and thrombosis syndrome (HITTS): 0.75 mg/kg as an IV bolus dose, followed immediately by 1.75 mg/kg/hr IV for the duration of the percutaneous coronary intervention (PCI)/percutaneous transluminal coronary angioplasty (PTCA) procedure; 5 minutes after the bolus dose, an activated clotting time (ACT) should be performed and an additional bolus of 0.3 mg/kg IV should be given if needed
- Administration of a glycoprotein IIb/IIIa inhibitor (GPI) 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
For patients who have HIT/HITTS undergoing PCI:
0.75 mg/kg IV as a bolus dose, followed immediately by 1.75 mg/kg/hr IV for the duration of the procedure
For ongoing treatment post procedure:
- The infusion may be continued following PCI/PTCA for up to 4 hours post procedure at the discretion of the physician.
- In patients with ST segment elevation myocardial infarction (STEMI), continuation of the infusion at a rate of 1.75 mg/kg/hr IV following PCI/PTCA for up to 4 hours post procedure should be considered to mitigate risk of stent thrombosis.
- After 4 hours, an additional IV infusion may be initiated at a rate of 0.2 mg/kg/hr IV (low-rate infusion) for up to 20 hours, if needed.
Comments:
- This drug is intended for use with aspirin and has been studied only in patients receiving concomitant aspirin.
Uses:
- For use as an anticoagulant in patients with unstable angina undergoing PTCA
- For use an anticoagulant in patients undergoing PCI with provisional use of GPI
- For use as an anticoagulant in patients with, or at risk of, HIT or HITTS, undergoing PCI
Usual Adult Dose for Percutaneous Coronary Intervention
For patients who do not have heparin-induced thrombocytopenia (HIT) or heparin-induced thrombocytopenia and thrombosis syndrome (HITTS): 0.75 mg/kg as an IV bolus dose, followed immediately by 1.75 mg/kg/hr IV for the duration of the percutaneous coronary intervention (PCI)/percutaneous transluminal coronary angioplasty (PTCA) procedure; 5 minutes after the bolus dose, an activated clotting time (ACT) should be performed and an additional bolus of 0.3 mg/kg IV should be given if needed
- Administration of a glycoprotein IIb/IIIa inhibitor (GPI) 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
For patients who have HIT/HITTS undergoing PCI:
0.75 mg/kg IV as a bolus dose, followed immediately by 1.75 mg/kg/hr IV for the duration of the procedure
For ongoing treatment post procedure:
- The infusion may be continued following PCI/PTCA for up to 4 hours post procedure at the discretion of the physician.
- In patients with ST segment elevation myocardial infarction (STEMI), continuation of the infusion at a rate of 1.75 mg/kg/hr IV following PCI/PTCA for up to 4 hours post procedure should be considered to mitigate risk of stent thrombosis.
- After 4 hours, an additional IV infusion may be initiated at a rate of 0.2 mg/kg/hr IV (low-rate infusion) for up to 20 hours, if needed.
Comments:
- This drug is intended for use with aspirin and has been studied only in patients receiving concomitant aspirin.
Uses:
- For use as an anticoagulant in patients with unstable angina undergoing PTCA
- For use an anticoagulant in patients undergoing PCI with provisional use of GPI
- For use as an anticoagulant in patients with, or at risk of, HIT or HITTS, undergoing PCI
Renal Dose Adjustments
- No reduction in the bolus dose is recommended for any degree of renal impairment
- CrCl less than 30 mL/min: Reduce the infusion dose to 1 mg/kg/hr
Liver Dose Adjustments
Data not available
Precautions
Safety and efficacy have not been established in patients younger than 18 years.
Consult WARNINGS section for additional precautions.
Dialysis
Hemodialysis: No change in bolus dose; however, the infusion rate should be reduced to 0.25 mg/kg/hr
Peritoneal dialysis: Data not available
Other Comments
Storage requirements:
- The manufacturer product information should be consulted.
Reconstitution/preparation techniques:
- The manufacturer product information should be consulted.
IV compatibility:
- The manufacturer product information should be consulted.
General:
- This drug is intended for use with aspirin and has been studied only in patients receiving concomitant aspirin.
More about bivalirudin
- Check interactions
- Compare alternatives
- Pricing & coupons
- Reviews (1)
- Side effects
- During pregnancy
- Drug class: thrombin inhibitors
- Breastfeeding
- En español
Patient resources
Other brands
Professional resources
Other brands
Related treatment guides
See also:
Enoxaparin
Enoxaparin is used for acute coronary syndrome, angina, deep vein thrombosis, deep vein thrombosis ...
Verapamil
Verapamil is used to treat hypertension (high blood pressure), angina (chest pain), and certain ...
Botox
Botox is used cosmetically to reduce facial lines and wrinkles and for medical purposes for ...
Atenolol
Atenolol is used to treat angina (chest pain) and hypertension (high blood pressure). Learn about ...
Nitroglycerin
Nitroglycerin is used for anal fissure and fistula, angina, angina pectoris prophylaxis, heart ...
Propranolol
Propranolol is a beta-blocker that is used to treat tremors, chest pain, high blood pressure, heart ...
Carvedilol
Carvedilol (Coreg) is used to treat heart failure and hypertension (high blood pressure). Includes ...
Aspirin
Aspirin is used to treat mild to moderate pain and to reduce fever or inflammation. Learn about ...
Metoprolol
Metoprolol is used to treat angina (chest pain) and hypertension (high blood pressure). Learn about ...
Amlodipine
Amlodipine is a calcium channel blocker used to treat high blood pressure and angina by relaxing ...
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.