Bivalirudin
Also known as: Angiomax, Angiox, Hirulog
A synthetic 20-amino-acid direct thrombin inhibitor used as an IV anticoagulant during PCI. FDA-approved as Angiomax (2000). Hospital medication.
Last updated
Mechanism of Action
Bivalirudin is a synthetic analog of hirudin, the leech anticoagulant. It binds both the active catalytic site and the substrate-recognition exosite of thrombin, blocking circulating and clot-bound thrombin directly without needing antithrombin. Thrombin slowly cleaves bivalirudin itself, so its effect is reversible and short-lived, and it is cleared partly by the kidneys.
- Half-life
- ~25 minutes (IV; longer with kidney impairment)
- Administration Routes
- Intravenous
- Research Status
- Clinical
Reported Benefits
- Anticoagulation during percutaneous coronary intervention (PCI)
- An option for PCI in patients with or at risk of heparin-induced thrombocytopenia
- Studied versus heparin in acute coronary syndromes and STEMI
Potential Side Effects
- Bleeding (the main risk)
- Acute stent thrombosis, reported in STEMI patients
- Back pain, nausea and headache
- Hypotension
Common Dosing
Bivalirudin is given only in the cardiac catheterization lab or hospital as an intravenous bolus followed by an infusion during and sometimes after PCI. Doses are weight-based, the infusion rate is reduced for kidney impairment, and clotting times are monitored. Dosing is set and supervised by the prescribing clinician.
The dosing information above is aggregated from research literature and anecdotal community reports for educational purposes only. It is not a recommendation, prescription, or medical advice. Peptides are sold as research chemicals only and are not intended for human use.
Contraindications
- Active major bleeding
- Known hypersensitivity to bivalirudin
No documented stacking partners for Bivalirudin yet.
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Bivalirudin during primary PCI in acute myocardial infarction
2008
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Bivalirudin for patients with acute coronary syndromes
2006
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Bivalirudin plus a high-dose infusion versus heparin monotherapy in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: a randomised trial
2022