Approved & therapeutic
Bivalirudin
Angiomax
Bivalirudin is a synthetic 20-amino-acid direct thrombin inhibitor, derived from hirudin in medicinal leech saliva, used as an anticoagulant in patients undergoing percutaneous coronary intervention.
Also known as: Angiox, Hirulog
- Status
- Bivalirudin is approved by the U.S. FDA and has official prescribing information.
- Evidence
- Approved labeling. Official prescribing information exists, based on clinical trials in people.
- Half-life
- Approximately 25 minutes in patients with normal renal function; prolonged in renal impairment.
- How it's taken
- Intravenous bolus followed by continuous infusion, in a procedural setting
- Mechanism
- Other
How Bivalirudin works
Bivalirudin binds thrombin bivalently — one end occupies the catalytic site, the other the fibrinogen-binding exosite — inhibiting both free and clot-bound thrombin. Unlike heparin it does not require antithrombin as a cofactor. Thrombin slowly cleaves the bound bivalirudin, so inhibition is self-limiting and recovers predictably.
What research has looked at
- Inhibits clot-bound thrombin, which heparin-antithrombin complexes cannot reach.
- Does not cause or interact with heparin-induced thrombocytopenia, making it a standard choice in patients with HIT or a history of it.
- Predictable, dose-proportional anticoagulation without the need for routine monitoring or an antithrombin cofactor.
- The reversible, self-limiting nature of thrombin binding gives rapid offset once the infusion stops.
Evidence level: Approved labeling. Official prescribing information exists, based on clinical trials in people. These are areas studied or reported, not promised effects.
Reported side effects and risks
- Bleeding is the principal risk, as with any anticoagulant.
- There is no specific reversal agent; management of major bleeding relies on stopping the infusion and supportive measures. The short half-life is what makes this workable.
- It is cleared partly by the kidney, and the infusion rate must be reduced in renal impairment.
- Acute stent thrombosis has been reported in the periprocedural period in some primary PCI settings.
- Back pain, nausea, headache and hypotension were reported in trials.
Sources
- FDA approved-drug listing for bivalirudin · U.S. Food & Drug Administration
- DailyMed prescribing information for bivalirudin · NIH · DailyMed
- PubMed research on bivalirudin direct thrombin inhibitor PCI · NIH · National Library of Medicine
- DrugBank record for bivalirudin · DrugBank
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Bivalirudin FAQ
What is Bivalirudin?
Bivalirudin is a synthetic 20-amino-acid direct thrombin inhibitor, derived from hirudin in medicinal leech saliva, used as an anticoagulant in patients undergoing percutaneous coronary intervention.
How does Bivalirudin work?
Bivalirudin binds thrombin bivalently — one end occupies the catalytic site, the other the fibrinogen-binding exosite — inhibiting both free and clot-bound thrombin. Unlike heparin it does not require antithrombin as a cofactor. Thrombin slowly cleaves the bound bivalirudin, so inhibition is self-limiting and recovers predictably.
Is Bivalirudin FDA approved?
Yes. Bivalirudin is approved by the U.S. FDA and has official prescribing information. Evidence level: approved labeling. Official prescribing information exists, based on clinical trials in people.
What is the half-life of Bivalirudin?
Reported half-life: Approximately 25 minutes in patients with normal renal function; prolonged in renal impairment.
How is Bivalirudin taken?
Intravenous bolus followed by continuous infusion, in a procedural setting.
What side effects have been reported with Bivalirudin?
Reported in the sources: Bleeding is the principal risk, as with any anticoagulant; There is no specific reversal agent; management of major bleeding relies on stopping the infusion and supportive measures. The short half-life is what makes this workable; It is cleared partly by the kidney, and the infusion rate must be reduced in renal impairment; Acute stent thrombosis has been reported in the periprocedural period in some primary PCI settings; Back pain, nausea, headache and hypotension were reported in trials.
Educational summary compiled from the sources listed above. Not medical advice. Peptide Vault does not sell, source or recommend any compound. Talk to a qualified clinician before starting or changing anything.