# Bivalirudin

> 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.

- URL: https://www.lifeconverted.com/peptides/bivalirudin
- Also known as: Angiomax, Angiox
- Primary category: Other & Clinical
- Effectiveness rank: #14 in Other & Clinical
- Evidence level: Well studied
- Route: Intravenous (Administered as an intravenous bolus followed by a continuous infusion, with weight-based (mg/kg) dosing.)
- Dose range: 0.75-2.5 mg
- Dose tiers: low 0.75 mg; moderate 1.75 mg; high 2.5 mg
- Half-life: Approximately 25 minutes with normal renal function
- Timing: As directed by your clinician
- Cycle: Single procedural IV administration (bolus plus infusion) during PCI on, Discontinued at the end of the procedure off (Not a repeat-dosed or cycled peptide; used acutely during a single procedure under continuous monitoring.)
- Storage: Store the lyophilized vial at room temperature (20-25°C); reconstituted/diluted solution should be refrigerated if not used immediately, per label timing limits.

## Mechanism of action

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.

## 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

## Reported side effects

- 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

## Common protocols

- Percutaneous coronary intervention (PCI) procedural anticoagulation
- Anticoagulation in patients with heparin-induced thrombocytopenia undergoing PCI

## Stacking notes

Used alongside antiplatelet therapy (e.g., aspirin, P2Y12 inhibitors) per standard PCI anticoagulation protocols; not combined with other injectable peptides.

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