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Health Guide

Bivalirudin (Intravenous route)

Pronunciation:

bye-VAL-i-roo-din

Brand Names:

  • Angiomax

Dosage Forms:

  • Powder for Solution

Classifications:

Therapeutic

Anticoagulant

Pharmacologic

Thrombin Inhibitor, Direct

Chemical

Hirudin Related

Uses of This Medicine:

Bivalirudin is used together with aspirin to decrease the clotting ability of the blood and to help prevent harmful clots from forming in the blood vessels. It is used in patients who are having certain heart and blood vessel procedures, such as coronary angioplasty.

This medicine is available only with your doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children

Appropriate studies have not been performed on the relationship of age to the effects of bivalirudin in the pediatric population. Safety and efficacy have not been established.

Older adults

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of bivalirudin in the elderly. However, elderly patients are more likely to have bleeding problems than younger adults, which may require caution in patients receiving bivalirudin.

Pregnancy

Pregnancy CategoryExplanation
All TrimestersBAnimal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breast-feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Defibrotide

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Abciximab
  • Aceclofenac
  • Acemetacin
  • Acenocoumarol
  • Alipogene Tiparvovec
  • Alteplase, Recombinant
  • Amtolmetin Guacil
  • Anagrelide
  • Anistreplase
  • Apixaban
  • Argatroban
  • Aspirin
  • Bemiparin
  • Bromfenac
  • Bufexamac
  • Cangrelor
  • Celecoxib
  • Chamomile
  • Choline Salicylate
  • Cilostazol
  • Citalopram
  • Clonixin
  • Clopidogrel
  • Collagenase, Clostridium histolyticum
  • Dabigatran Etexilate
  • Dalteparin
  • Danaparoid
  • Desvenlafaxine
  • Dexibuprofen
  • Dexketoprofen
  • Diclofenac
  • Diflunisal
  • Dipyridamole
  • Dipyrone
  • Drotrecogin Alfa
  • Droxicam
  • Edoxaban
  • Enoxaparin
  • Epoprostenol
  • Eptifibatide
  • Escitalopram
  • Etodolac
  • Etofenamate
  • Etoricoxib
  • Felbinac
  • Fenofibrate
  • Fenofibric Acid
  • Fenoprofen
  • Fepradinol
  • Feprazone
  • Floctafenine
  • Flufenamic Acid
  • Fluoxetine
  • Flurbiprofen
  • Fluvoxamine
  • Fondaparinux
  • Garlic
  • Ginkgo
  • Heparin
  • Ibuprofen
  • Iloprost
  • Indomethacin
  • Ketoprofen
  • Ketorolac
  • Lepirudin
  • Levomilnacipran
  • Lornoxicam
  • Loxoprofen
  • Lumiracoxib
  • Meclofenamate
  • Mefenamic Acid
  • Meloxicam
  • Milnacipran
  • Morniflumate
  • Nabumetone
  • Nadroparin
  • Naproxen
  • Nepafenac
  • Niflumic Acid
  • Nimesulide
  • Nimesulide Beta Cyclodextrin
  • Nintedanib
  • Orlistat
  • Oxaprozin
  • Oxyphenbutazone
  • Papaya
  • Parecoxib
  • Paroxetine
  • Pentosan Polysulfate Sodium
  • Phenindione
  • Phenprocoumon
  • Phenylbutazone
  • Piketoprofen
  • Piracetam
  • Piroxicam
  • Pranoprofen
  • Prasugrel
  • Proglumetacin
  • Propyphenazone
  • Proquazone
  • Reteplase, Recombinant
  • Rivaroxaban
  • Rofecoxib
  • Selexipag
  • Sertraline
  • St John's Wort
  • Streptokinase
  • Sulfinpyrazone
  • Sulindac
  • Tan-Shen
  • Tenecteplase
  • Tenoxicam
  • Tiaprofenic Acid
  • Ticagrelor
  • Ticlopidine
  • Tinzaparin
  • Tirofiban
  • Tolfenamic Acid
  • Tolmetin
  • Treprostinil
  • Urokinase
  • Valdecoxib
  • Venlafaxine
  • Vilazodone
  • Vorapaxar
  • Vortioxetine
  • Warfarin

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Chondroitin
  • Coenzyme Q10
  • Curcumin
  • Dong Quai
  • Ginger
  • Vitamin A

Other interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

  • Avocado

Other medical problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Bleeding problems, active Should not be used in patients with this condition.
  • Brachytherapy (a radiation treatment) Use with caution. Your chance of having blot clots may be increased.
  • Kidney disease Use with caution. May require an adjustment of dosage for patients with this condition.

Proper Use of This Medicine:

A nurse or other trained health professional will give you this medicine. This medicine is given through a needle placed into one of your veins.

Precautions While Using This Medicine:

It is very important that your doctor check you at regular visits after you leave the hospital for any problems or unwanted effects that may be caused by this medicine. Be sure to keep all appointments.

Bivalirudin may increase your chance of bleeding. Check with your doctor right away if you notice any unusual bleeding or bruising; black, tarry stools; blood in the urine or stools; or pinpoint red spots on your skin. Avoid picking your nose. If you need to blow your nose, blow it gently.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common
Abdominal pain or swelling
arm, back, or jaw pain
black, tarry stools
blood in the eyes
blood in the urine
blurred vision
bruising or purple areas on the skin
chest pain or discomfort
chest tightness or heaviness
confusion
coughing up blood
decreased alertness
dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
headache
joint pain or swelling
nausea
nervousness
nosebleeds
pounding in the ears
shortness of breath
slow, fast, or irregular heartbeat
sweating
unusual tiredness or weakness
Less common
Decrease in frequency of urination
decrease in urine volume
difficulty in passing urine (dribbling)
lightheadedness or fainting
painful urination
Rare
Blue lips and fingernails
changes in skin color
cold hands and feet
cough or hoarseness
coughing that sometimes produces a pink frothy sputum
difficult, fast, noisy breathing, sometimes with wheezing
fever or chills
increased blood pressure
increased thirst
loss of appetite
lower back or side pain
pain, redness, or swelling in the arm or leg
pale skin
paralysis of the face
rapid, shallow breathing
severe numbness, especially on one side of the face or body
swelling in the legs and ankles
swelling of the face, fingers, or lower legs
troubled breathing
vomiting
weight gain
Incidence not known
Bleeding gums
difficulty in swallowing
hives
increased menstrual flow or vaginal bleeding
irritation
itching
joint stiffness
pains in the chest, groin, or legs, especially calves of legs
paralysis
prolonged bleeding from cuts
rash
red or dark brown urine
redness of the skin
severe headaches of sudden onset
sudden loss of coordination
sudden onset of shortness of breath for no apparent reason
sudden onset of slurred speech
sudden vision changes
swelling of the eyelids, lips, hands, or feet
wheezing

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
Fear or nervousness
pain where the needle is placed
pelvic pain
sleeplessness
trouble sleeping
unable to sleep
Less common
Acid or sour stomach
belching
heartburn
indigestion
stomach discomfort, upset, or pain

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 10/12/2016
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