Biva250mg/5ml
Rx- Generic:
- Bivalirudin
- Company:
- Healthcare Pharmaceuticals Ltd.
- Dosage form:
- Injection
- Pack size:
- 250mg Vial
৳ 10,000/unit
Pack: ৳ 10,000
At a glance
Bivalirudin is an anticoagulant (blood thinner) medicine used to prevent and treat blood clots. It is used as an anticoagulant in patients undergoing PTCA/PCI, unstable angina, heart attack, and heparin-induced thrombocytopenia (HIT/HITTS).
Indications
- Anticoagulant in patients undergoing PTCA/PCI
- PCI with HIT/HITTS (heparin-induced thrombocytopenia/thrombosis syndrome)
- Unstable angina/Non-ST-Elevation MI (off-label)
- STEMI undergoing primary PCI (off-label)
- Heparin-induced thrombocytopenia
Dosage
PCI/PTCA: IV Bolus: 0.75 mg/kg, then infusion: 1.75 mg/kg/h for the duration of the PCI procedure. Obtain ACT 5 minutes after bolus and administer additional 0.3 mg/kg bolus if indicated.
HIT/HITTS: IV Bolus: 0.75 mg/kg, followed by continuous infusion at 1.75 mg/kg/h for the duration of the procedure.
Post-procedure: Infusion may be continued for up to 4 hours post-procedure as indicated. After 4 hours, an additional infusion of 0.2 mg/kg/h for up to 20 hours may be given if needed.
Concomitant Therapy: Intended for use with aspirin (300-325 mg/day).
Renal Impairment:
CrCl 30-50 mL/min: Infusion rate 1.75 mg/kg/h
CrCl <30 mL/min: Reduce infusion rate to 1 mg/kg/h
Hemodialysis: Reduce infusion rate to 0.25 mg/kg/h (no reduction in bolus dose needed)
Hepatic impairment: No dosage adjustment needed.
Side effects
Common: Bleeding (bruising), hypotension, nausea, headache, fever, infection, sepsis.
Cardiovascular: Hypotension, syncope, vascular anomaly, ventricular fibrillation.
Nervous: Cerebral ischemia, confusion, facial paralysis.
Respiratory: Lung edema.
Urogenital: Kidney failure, oliguria.
Elderly patients experienced more bleeding events than younger patients.
Precautions & warnings
- Bleeding events: Most bleeding occurs at the arterial puncture site, but hemorrhage can occur at any site. An unexplained fall in blood pressure or hematocrit should lead to consideration of a hemorrhagic event and cessation of bivalirudin.
- Use with caution in patients with conditions associated with increased bleeding risk.
- Coronary artery brachytherapy: Increased risk of thrombus formation with bivalirudin use in gamma brachytherapy.
- Notify your doctor if you see blood in vomit, urine, or stool (black, tarry stools or bright red blood).
- Caution with other anticoagulants.