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argatroban

Pronunciation

Generic Name: argatroban (ar GAT roe ban)
Brand Name: Acova

What is argatroban?

Argatroban helps to prevent platelets in your blood from sticking together and forming a blood clot.

Argatroban is used to treat or prevent blood clots in people who have thrombocytopenia (low levels of platelets in the blood) caused by using heparin. Argatroban is sometimes used in people who are undergoing a procedure called angioplasty (to open blocked arteries).

Argatroban may also be used for purposes not listed in this medication guide.

What is the most important information I should know about argatroban?

You should not use this medicine if you have any major bleeding from a surgery, injury, or other medical trauma.

Tell your doctor if you are using or receiving blood thinners or any other medications used to treat or prevent blood clots.

Argatroban can make it easier for you to bleed, even from a minor injury.

What should I discuss with my health care provider before receiving argatroban?

You should not receive this medicine if you are allergic to argatroban, or if you have any major bleeding from a surgery, injury, or other medical trauma.

To make sure argatroban is safe for you, tell your doctor if you have:

  • a stomach ulcer or bleeding;

  • liver disease;

  • a bleeding or blood clotting disorder (such as hemophilia);

  • untreated or uncontrolled high blood pressure (hypertension);

  • if you have recently had a spinal tap or epidural anesthesia; or

  • if you have recently had major surgery (especially eye surgery, brain surgery, or spinal cord surgery).

Argatroban is not expected to be harmful to an unborn baby. However, aspirin is sometimes given with argatroban, and taking aspirin during late pregnancy may cause bleeding in the mother or the baby during delivery. Tell your doctor if you are pregnant while taking aspirin.

It is not known whether argatroban passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How is argatroban given?

Argatroban is injected into a vein through an IV. You will receive this injection in a clinic or hospital setting. Argatroban is sometimes given together with aspirin.

If you are receiving this injection during an angioplasty procedure, the medicine will be given throughout the entire procedure and for up to 24 hours after the procedure.

Argatroban is given around the clock until your blood coagulates properly. Your doctor will test your blood often to determine how long to treat you with argatroban.

To be sure this medicine is helping your condition and is not causing harmful effects, your blood will need to be tested often. Visit your doctor regularly.

Because argatroban keeps your blood from coagulating (clotting) to prevent unwanted blood clots, it can also make it easier for you to bleed, even from a minor injury. Contact your doctor or seek emergency medical attention if you have bleeding that will not stop.

What happens if I miss a dose?

Since argatroban is given by a healthcare professional, you are not likely to miss a dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while receiving argatroban?

Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.

Avoid drinking alcohol. It may increase your risk of bleeding in your stomach or intestines.

Argatroban side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

  • a light-headed feeling, like you might pass out;

  • easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

  • blood in your urine;

  • black, bloody, or tarry stools;

  • coughing up blood or vomit that looks like coffee grounds;

  • any bleeding that will not stop;

  • pain or burning when you urinate;

  • sudden numbness or weakness, problems with vision, speech, or balance;

  • sudden severe headache, confusion, sudden changes in your senses of taste or touch;

  • fever, chills, body aches, flu symptoms;

  • cough with yellow or green mucus, stabbing chest pain, feeling short of breath;

  • slow heart rate, weak pulse, slow breathing (breathing may stop); or

  • chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling.

Common side effects may include:

  • nausea, vomiting, diarrhea, stomach pain;

  • headache;

  • back pain; or

  • bleeding around the IV needle.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Argatroban dosing information

Usual Adult Dose for Thrombotic/Thromboembolic Disorder:

Heparin-induced thrombocytopenic (HIT) thrombosis treatment or prophylaxis:
Initial: 2 mcg/kg/min administered as a constant infusion. Begin infusion only after obtaining a baseline activated partial thromboplastin time (aPTT).
Maintenance: The infusion rate may be adjusted as needed (not to exceed 10 mcg/kg/min) until the steady state aPTT value is 1.5 to 3 times the initial baseline value (not to exceed 100 seconds). Dosage adjustments should be based on aPTT results from blood samples obtained at least 2 hours after the most recent infusion rate change.

Percutaneous Coronary Interventions (PCI) in HIT/HITTS patients:
Initial: 25 mcg/kg/min infusion and a bolus of 350 mcg/kg administered via a large bore intravenous line over 3 to 5 minutes. Activated clotting time (ACT) should be checked 5 to 10 minutes after the bolus dose is completed. The procedure may proceed if the ACT is greater than 300 seconds.
If the ACT is less than 300 seconds, an additional IV bolus dose of 150 mcg/kg should be administered, the infusion dose increased to 30 mcg/kg/min, and the ACT checked 5 to 10 minutes later. If the ACT is greater than 450 seconds, the infusion rate should be decreased to 15 mcg/kg/min, and the ACT checked 5 to 10 minutes later. Once a therapeutic ACT (between 300 and 450 seconds) has been achieved, this infusion dose should be continued for the duration of the procedure.

Usual Pediatric Dose for Thrombotic/Thromboembolic Disorder:

Infants and Children 16 years or younger: The safety and effectiveness of argatroban, including the appropriate anticoagulation goals and duration of therapy, have not been established among pediatric patients.

Note: Limited data available; dosing regimens not established. Titration of maintenance dose must consider multiple factors including current argatroban dose, current aPTT, target aPTT, and clinical status of the patient. For specific uses, required maintenance dose is highly variable between patients. Additionally, during the course of treatment, patient's dosing requirements may change as clinical status changes (e.g., sicker patients require lower dose); frequent dosage adjustments may be required to maintain desired anticoagulant activity. If argatroban therapy is used concurrently with or following FFP or a thrombolytic, some centers decrease dose by half.

Heparin-induced thrombocytopenia:
Initial dose: 0.75 mcg/kg/minute by continuous IV infusion
Maintenance dose: Measure aPTT after 2 hours; adjust dose until the steady-state aPTT is 1.5 to 3 times the initial baseline value, not exceeding 100 seconds; adjust in increments of 0.1 to 0.25 mcg/kg/minute for normal hepatic function; reduce dose in hepatic impairment (see liver dose adjustment).
Note: A lower initial infusion rate may be needed in other pediatric patients with reduced clearance of argatroban (e.g., patients with heart failure, multiple organ system failure, severe anasarca, or postcardiac surgery). This precaution is based on adult studies of patients with these disease states who had reduced argatroban clearance.

What other drugs will affect argatroban?

Tell your doctor about all other medications you use or have recently received to prevent blood clots, such as:

  • a blood thinner such as heparin or warfarin (Coumadin, Jantoven);

  • abciximab (ReoPro), anagrelide (Agrylin), cilostazol (Pletal), clopidogrel (Plavix), dipyridamole (Persantine, Aggrenox), eptifibatide (Integrelin), prasugrel (Effient), ticlopidine (Ticlid), tirofiban (Aggrastat);

  • dabigatran (Pradaxa), bivalirudin (Angiomax), lepirudin (Refludan);

  • dalteparin (Fragmin), enoxaparin (Lovenox), fondaparinux (Arixtra), tinzaparin (Innohep); or

  • alteplase (Activase), tenecteplase (TNKase), urokinase (Abbokinase).

This list is not complete. Other drugs may interact with argatroban, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about argatroban.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 2.02.

Last reviewed: August 15, 2015
Date modified: November 30, 2016

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