Dosage of bivalirudin

Bivalirudin is a parenteral direct thrombin (factor IIa) inhibitor. Because bivalirudin has a short half-life (approximately 25 minutes), it is given as a continuous intravenous infusion; a loading dose is required for some indications. Bivalirudin is predominantly excreted via the kidneys so it should not be used in patients with a calculated creatinine clearance (CrCl) less than 30 mL/min.

The dosage of bivalirudin varies according to the indication. For example:

• acute coronary syndromes (see Percutaneous coronary intervention for STEMI and Parenteral anticoagulant therapy for NSTEACS)
• heparin-induced thrombocytopenia (HIT).