Skip to Content

Bivalirudin Side Effects

For the Consumer

Applies to bivalirudin: intravenous powder for solution

Along with its needed effects, bivalirudin may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur while taking bivalirudin:

More common
  • Abdominal pain or swelling
  • arm, back, or jaw pain
  • black, tarry stools
  • blood in the eyes
  • blood in the urine
  • blurred vision
  • bruising or purple areas on the skin
  • chest pain or discomfort
  • chest tightness or heaviness
  • confusion
  • coughing up blood
  • decreased alertness
  • dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
  • headache
  • joint pain or swelling
  • nausea
  • nervousness
  • nosebleeds
  • pounding in the ears
  • shortness of breath
  • slow, fast, or irregular heartbeat
  • sweating
  • unusual tiredness or weakness
Less common
  • Decrease in frequency of urination
  • decrease in urine volume
  • difficulty in passing urine (dribbling)
  • lightheadedness or fainting
  • painful urination
  • Blue lips and fingernails
  • changes in skin color
  • cold hands and feet
  • cough or hoarseness
  • coughing that sometimes produces a pink frothy sputum
  • difficult, fast, noisy breathing, sometimes with wheezing
  • fever or chills
  • increased blood pressure
  • increased thirst
  • loss of appetite
  • lower back or side pain
  • pain, redness, or swelling in the arm or leg
  • pale skin
  • paralysis of the face
  • rapid, shallow breathing
  • severe numbness, especially on one side of the face or body
  • swelling in the legs and ankles
  • swelling of the face, fingers, or lower legs
  • troubled breathing
  • vomiting
  • weight gain
Incidence not known
  • Bleeding gums
  • difficulty in swallowing
  • hives
  • increased menstrual flow or vaginal bleeding
  • irritation
  • itching
  • joint stiffness
  • pains in the chest, groin, or legs, especially calves of legs
  • paralysis
  • prolonged bleeding from cuts
  • rash
  • red or dark brown urine
  • redness of the skin
  • severe headaches of sudden onset
  • sudden loss of coordination
  • sudden onset of shortness of breath for no apparent reason
  • sudden onset of slurred speech
  • sudden vision changes
  • swelling of the eyelids, lips, hands, or feet
  • wheezing

Some side effects of bivalirudin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common Less common

For Healthcare Professionals

Applies to bivalirudin: intravenous powder for injection


Common (1% to 10%): Atrial fibrillation, ventricular tachycardia, angina pectoris, bradycardia, hypertension, hypotension, chest pain
Rare (less than 0.1%): Myocardial infarction, cardiac tamponade, pericardial hemorrhage, coronary artery thrombosis, coronary stent thrombosis (including reports with fatal outcome), arteriovenous fistula, catheter thrombosis, vascular pseudoaneurysm
Postmarketing reports: Cardiac tamponade, ventricular fibrillation[Ref]


Uncommon (0.1% to 1%): Epistaxis, hemoptysis, pharyngeal hemorrhage
Rare (less than 0.1%): Pulmonary hemorrhage, dyspnea[Ref]


Uncommon (0.1% to 1%): Rash, urticaria[Ref]


Common (1% to 10%): Nausea, vomiting, dyspepsia
Uncommon (0.1% to 1%): GI hemorrhage (i.e., hematemesis, melena, esophageal hemorrhage, anal hemorrhage), retroperitoneal hemorrhage, gingival hemorrhage
Rare (less than 0.1%): Retroperitoneal hematoma[Ref]


Uncommon (0.1% to 1%): Hematuria[Ref]


Very common (10% or more): Minor hemorrhage at any site (22%)
Common (1% to 10%): Hemoglobin decreased, major hemorrhage at any site (including fatal outcomes)
Uncommon (0.1% to 1%): Thrombocytopenia, anemia, hematoma
Rare (less than 0.1%): INR increased
Postmarketing reports: Catheter thrombosis, arteriovenous fistula, compartment syndrome[Ref]


Uncommon (0.1% to 1%): Anaphylaxis (including fatal shock)[Ref]


Common (1% to 10%): Access site hemorrhage, vessel puncture site hematoma (5 cm or less), vessel puncture site hematoma (greater than 5 cm), injection site pain
Rare (less than 0.1%): Injection site reactions (i.e., injection site discomfort, injection site pain, puncture site reaction)[Ref]


Very common (10% or more): Back pain
Common (1% to 10%): Chest pain[Ref]

Nervous system

Common (1% to 10%): Headache, insomnia
Rare (less than 0.1%): Intracranial hemorrhage[Ref]


Rare (less than 0.1%): Intraocular hemorrhage[Ref]


Rare (less than 0.1%): Ear hemorrhage[Ref]


Common (1% to 10%): Nervousness[Ref]


1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

2. "Product Information. Angiomax (bivalirudin)" The Medicines Compny, Cambridge, MA.

3. "Product Information. Bivalirudin (bivalirudin)." Fresenius Kabi USA, Lake Zurich, IL.

Some side effects of bivalirudin may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. 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 substances you are taking, check with your doctor, nurse, or pharmacist.