Performance Comparison of Microfluidic and Immunomagnetic Platforms for Pancreatic CTC Enrichment
November 15, 2025
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Brand Name :
Angiomax RTU,Angiomax
Synonyms :
bivalirudin
Class :
Hematologists, Anti-coagulants; Cardiovascular, Anti-coagulants
Brand Name :
Angiomax RTU,Angiomax
Synonyms :
bivalirudin
Class :
Hematologists, Anti-coagulants; Cardiovascular, Anti-coagulants
Dosage Forms & StrengthsÂ
Powder for reconstitution, Injection Â
250mg/vialÂ
Ready-to-use solution, InjectionÂ
5mg/mL (250mg/50mL; 500mg/100mL)Â
Â
Percutaneous Intervention (PCI)Â
Indicated for Percutaneous Coronary Intervention:
0.75mg/kg Intravenous bolus, followed by 1.75 mg/kg/hr intravenous infusion throughout the procedure
Obtain the activated coagulation time (ACT) 5 minutes after administering the bolus dose; if necessary, administer an additional intravenous bolus of 0.3 mg/kg
Consider an extended infusion duration of 1.75 mg/kg/hr for up to 4 hours following PCI in patients with ST-segment elevation MI. (STEMI)
Dose Adjustments
Hepatic Impairment
No Dose Modification Is Necessary
Renal Impairment
Bolus dose:
No dosage adjustment is necessary
Intravenous infusion:
Moderate (CrCl 30-59 mL/min): 1.75 mg/kg/hr
Hemodialysis: 0.25 mg/kg/hr
Severe (CrCl <30 mL/min): 1 mg/kg/hr
(Off Label):
Initial dose: 0.15–0.2 mg/kg/hr intravenous; increase to 1.5–2.5 times the standard amount for aPTT
Safety and efficacy not establishedÂ
Refer adult dosingÂ
bivalirudin: it may increase the risk of methemoglobinemia agents
bivalirudin: it may increase the risk of methemoglobinemia agents
bivalirudin: it may increase the risk of methemoglobinemia agents
bivalirudin: it may increase the risk of methemoglobinemia agents
bivalirudin: it may increase the risk of methemoglobinemia agents
may have an increased risk of hemorrhage when combined with bivalirudin
may enhance the effect of each other when combined
It may diminish the effect when combined with phenobarbital by enhancing metabolism
piperacillin will increase the effectiveness of bivalirudin by anticoagulation.
when both drugs are combined, there may be an increased effect of bivalirudin by anticoagulation  
when both drugs are combined, there may be an increased effect of bivalirudin by anticoagulation  
when both drugs are combined, there may be an increased effect of bivalirudin by anticoagulation  
may increase the toxicity of each other through anti coagulation
relugolix/​estradiol/​norethindroneÂ
may diminish the effects of each other by pharmacodynamic antagonism
anticoagulants increase the effect of anticoagulation of rivaroxaban
it increases the effect of anticoagulants
may have an increased anticoagulant effect when combined with anticoagulants
may have an increased thrombogenic effect when combined with anti- coagulant inhibitor complex
the activity of bivaluridin is reduced by butabarbital by enhancing metabolism
may increase the anticoagulant effect of anticoagulants
may increase the anti-coagulant effect of anti-coagulants
may increase the anticoagulant effect of Anticoagulants
may increase the anticoagulant effect of Anticoagulants
may increase the toxic effect of anti-coagulants
may increase the anti-coagulant effect of Anti-coagulants
may increase the anti-coagulant effect of Anti-coagulants
may increase the anti-coagulant effect of Anti-coagulants
may increase the anti-coagulant effect of Anti-coagulants
may increase the anti-coagulant effect of Anti-coagulants
may increase the anti-coagulant effect of Anti-coagulants
may increase the anti-coagulant effect of Anti-coagulants
may increase the anti-coagulant effect of Anti-coagulants
may increase the anti-coagulant effect of Anti-coagulants
may increase the anti-coagulant effect of Anti-coagulants
may increase the anti-coagulant effect of Anti-coagulants
It may enhance the risk of bleeding by affecting coagulation when combined with omega-3 carboxylic acids
may increase the anticoagulation when combined with ginkgo biloba
It may diminish the effects when combined with estradiol valerate by pharmacodynamic antagonism
When bivalirudin is used together with sertraline, the risk or seriousness of bleeding may be enhanced
The potential for bleeding risk or its seriousness may elevate when bivalirudin is used together with troxerutin
When bivalirudin is used together with andrographolide, this leads to enhanced risk or seriousness of bleeding
bivalirudin: it may increase the risk of bleeding with trapidil
bivalirudin: it may decrease the therapeutic efficacy of soyabean oil
the effects of bivalirudin increases by unknown function.
reduce therapeutic effects of bivalirudin
the effect of bivalirudin is increased by fluorouracil through the unspecific mechanism of interaction
may increase the anti-coagulant effect of antiplatelet agents
may enhance the anticoagulant effect
may increase the anticoagulant effect of pentosan polysulfate sodium
anticoagulation is increased by bivalirudin and decreased by mistletoe. The interaction's effect is unclear; exercise caution
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the levels of serum concentration
may increase the effect of anticoagulant activity
may increase the effect of anticoagulant activity
may increase the effect of anticoagulant activity
may increase the effect of anticoagulant activity
may increase the effect of anticoagulant activity
The anticoagulant effects of ancord may be enhanced when administered concomitantly with other anticoagulants
the risk of hemorrhage may be increased
the risk of bleeding may be increased
the risk of bleeding may be increased
miconazole nitrate/hydrocortisoneÂ
the activity of oral anticoagulants may be increased
ceforanide: it may decrease the excretion rate of bivalirudin
it may increase the anticoagulant effect
demeclocycline may increase the therapeutic effects of the bivalirudin
doxycycline may increase the therapeutic effects of the bivalirudin
Actions and Spectrum:Â
Frequency definedÂ
>10%Â
General pain (15%)Â
Hemorrhage, minor (13.6%)Â
Hypotension (12%)Â
Back pain (42%)Â
Nausea (15%)Â
Headache (12%)Â Â
1-10%Â
Insomnia (7%)Â
Hypertension (6%)Â
Vomiting (6%)Â
Dyspepsia (5%)Â
Fever (5%)Â
Urinary retention (4%)Â
≥3g/dL fall in Hgb (1.9%)Â
RBC transfusions (1.3%)Â
Injection site pain (8%)Â
Pelvic pain (6%)Â
Anxiety (6%)Â
Bradycardia (5%)Â
Abdominal pain (5%)Â
Nervousness (5%)Â
Hemorrhage, major (2.3%)Â
TIMI minor bleeding (1.3%)Â
Post-marketing reportsÂ
Pulmonary hemorrhageÂ
INR increasedÂ
Cardiac tamponadeÂ
Contraindications/caution:Â
Contraindications:Â
Caution:Â
Pregnancy consideration: Insufficient data availableÂ
Lactation: Excretion of the drug in human breast milk is unknownÂ
Pregnancy category:Â
Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester.  Â
Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.Â
Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.   Â
Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.   Â
Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.   Â
Category N: There is no data available for the drug under this categoryÂ
Pharmacology:Â
bivalirudin is a synthetic polypeptide that inhibits thrombin, a key enzyme in the coagulation cascade. Thrombin converts fibrinogen to fibrin, forming a clot that stops bleeding. bivalirudin binds to the active site of thrombin, preventing it from converting fibrinogen to fibrin and thereby preventing clot formation. Â
bivalirudin has a rapid onset of action and a short half-life, making it an attractive alternative to heparin in specific clinical settings. It is given by intravenous infusion and has a dose-dependent anti-coagulant effect.Â
Pharmacodynamics:Â
bivalirudin is a direct thrombin inhibitor used as an anticoagulant in patients undergoing percutaneous coronary intervention (PCI) and those with heparin-induced thrombocytopenia (HIT). The pharmacodynamics of bivalirudin is characterized by its ability to bind to the active site of thrombin and inhibit its function. Â
bivalirudin inhibits thrombin by specifically binding to its active site, which prevents the conversion of fibrinogen to fibrin and subsequently reduces the formation of blood clots. bivalirudin has a rapid onset of action and a short half-life, making it an attractive option for PCI procedures.Â
Pharmacokinetics:Â
AbsorptionÂ
bivalirudin is administered intravenously and is rapidly and completely absorbed into the bloodstream. Â
DistributionÂ
bivalirudin has a low volume of distribution and is mainly distributed in the plasma. It does not bind significantly to plasma proteins, and its distribution is not affected by age, sex, or body weight. Â
MetabolismÂ
bivalirudin is metabolized by proteolytic cleavage by plasma proteases, including thrombin and other serine proteases. bivalirudin metabolites are inactive and eliminated from the body by the kidneys. Â
Elimination and ExcretionÂ
bivalirudin is eliminated primarily by the kidneys, with about 20% of the drug excreted unchanged in the urine. bivalirudin clearance depends on renal function, and dosage adjustment is recommended in patients with impaired renal function.Â
Administration:Â
Patient information leafletÂ
Generic Name: bivalirudinÂ
Why do we use bivalirudin?Â
bivalirudin is a medication that is primarily used as an anticoagulant in two clinical settings:Â
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