Bivalirudin
Also known as Angiomax, Angiox
Bivalirudin is a synthetic 20-amino-acid direct thrombin inhibitor derived from the leech-derived anticoagulant hirudin. It is approved as a procedural anticoagulant during percutaneous coronary intervention (PCI) and for patients with heparin-induced thrombocytopenia undergoing PCI. Unlike heparin, its anticoagulant effect does not depend on antithrombin, giving it a more predictable and reversible pharmacologic profile during short procedures. It is used exclusively in acute, monitored clinical settings.
Reported benefits
- Provides effective procedural anticoagulation during PCI
- Associated with reduced bleeding risk relative to some heparin plus GP IIb/IIIa inhibitor regimens in certain trials
- Viable anticoagulant option in heparin-induced thrombocytopenia
- Short, predictable half-life suited to procedural use
How it works
Bivalirudin directly and reversibly binds both the catalytic active site and the fibrinogen-binding exosite of thrombin, blocking thrombin-mediated conversion of fibrinogen to fibrin and inhibiting platelet activation, independent of antithrombin.
Dosing ranges
| Tier | Dose | Frequency |
|---|---|---|
| Low | 0.75 mg | mg/kg IV bolus at the start of the procedure |
| Moderate | 1.75 mg | mg/kg/hour continuous IV infusion during PCI |
| High | 2.5 mg | mg/kg/hour, upper range used in select high-risk protocols |
Estimate your dose
Dose estimator
Educational estimate for Bivalirudin, scaled to body size. Not medical advice.
Read before using
This tool produces a rough, educational estimate by scaling commonly-published research ranges to lean body mass. It is not a prescription, medical advice, or a substitute for a licensed clinician. Most peptides use fixed dosing, not weight-based dosing. Individual needs vary. You are solely responsible for how you use this information.
Mixing & syringe units
Target dose follows the estimate above. Change it there, or edit it directly below.
Reconstitution calculator
How much water to add and how many insulin-syringe units to draw for Bivalirudin. Educational only.
Draw to this mark
35units
= 0.35 mL for a 1.75 mg dose
Concentration
5 mg/mL
Doses per vial
5
A U-100 syringe reads 100 units per mL. This is a reconstitution math helper only, not a prescription or dosing advice. Verify every calculation and consult a qualified healthcare provider.
Possible side effects
Stacking notes
Used alongside antiplatelet therapy (e.g., aspirin, P2Y12 inhibitors) per standard PCI anticoagulation protocols; not combined with other injectable peptides.
Common protocols
Common questions
What is Bivalirudin used for?
Bivalirudin is a synthetic 20-amino-acid direct thrombin inhibitor derived from the leech-derived anticoagulant hirudin. It is approved as a procedural anticoagulant during percutaneous coronary intervention (PCI) and for patients with heparin-induced thrombocytopenia undergoing PCI. Unlike heparin, its anticoagulant effect does not depend on antithrombin, giving it a more predictable and reversible pharmacologic profile during short procedures. It is used exclusively in acute, monitored clinical settings. Reported benefits include provides effective procedural anticoagulation during pci, associated with reduced bleeding risk relative to some heparin plus gp iib/iiia inhibitor regimens in certain trials, viable anticoagulant option in heparin-induced thrombocytopenia.
What is a typical Bivalirudin dose?
Reported ranges run 0.75-2.5 mg. A low protocol is 0.75 mg mg/kg iv bolus at the start of the procedure, and a high protocol is 2.5 mg mg/kg/hour, upper range used in select high-risk protocols. This is reference information, not a dosing recommendation.
What is the half life of Bivalirudin?
Approximately 25 minutes with normal renal function. That is what sets the dosing frequency, and it is why the timing guidance is as directed by your clinician.
How is Bivalirudin administered?
Intravenous: into a vein. Administered as an intravenous bolus followed by a continuous infusion, with weight-based (mg/kg) dosing.
How long is a Bivalirudin cycle?
Single procedural IV administration (bolus plus infusion) during PCI on, followed by Discontinued at the end of the procedure off. Not a repeat-dosed or cycled peptide; used acutely during a single procedure under continuous monitoring.
What are the side effects of Bivalirudin?
Reported side effects include bleeding, including at the vascular access site, gastrointestinal, or intracranial, hypotension, back pain, headache, thrombosis risk if dosing is inadequate or discontinued abruptly during a procedure. Evidence level for this compound is well studied.
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Educational use only, not medical advice. This profile is provided for research and educational purposes. Bivalirudin may be a research compound or a prescription medication; nothing here is intended to diagnose, treat, cure, or prevent any disease. Dosing figures reflect commonly-published research ranges, not a prescription. Consult a qualified healthcare provider before making any health decision. Read the full disclaimer →