Bivalirudin
Bivalirudin is a synthetic, specific, and reversible direct thrombin inhibitor (DTI). It works by directly binding to and inhibiting both circulating and clot-bound thrombin, thereby preventing thrombin-induced platelet aggregation and coagulation.
Dosage by Body Weight
Administered exclusively via intravenous bolus followed by a continuous intravenous infusion. Pediatric dosing is off-label, highly specialized, and must be closely monitored using Activated Clotting Time (ACT) or activated Partial Thromboplastin Time (aPTT). Dose adjustments are necessary for renal impairment.
- Body Weight
- Below 5 kg
- Dose
- Not routine
- Frequency
- Continuous IV infusion (if prescribed)
- Tracking Notes
- Off-label use. Requires highly specialized pediatric cardiology or intensive care monitoring. Standard pediatric bolus is 0.5 to 0.75 mg/kg, followed by 1.0 to 1.75 mg/kg/hour infusion, titrated to clinical target coagulation levels.
- Body Weight
- 5-7 kg
- Dose
- 0.5 to 0.75 mg/kg bolus, followed by 1.0 to 1.75 mg/kg/hour infusion
- Frequency
- Continuous IV infusion
- Tracking Notes
- Off-label use. Titrate infusion rate carefully based on ACT or aPTT monitoring. Monitor renal function closely.
- Body Weight
- 8-10 kg
- Dose
- 0.5 to 0.75 mg/kg bolus, followed by 1.0 to 1.75 mg/kg/hour infusion
- Frequency
- Continuous IV infusion
- Tracking Notes
- Off-label use. Requires inpatient monitoring. Discontinue infusion immediately if severe, unexpected bleeding occurs.
- Body Weight
- 11-15 kg
- Dose
- 0.5 to 0.75 mg/kg bolus, followed by 1.0 to 1.75 mg/kg/hour infusion
- Frequency
- Continuous IV infusion
- Tracking Notes
- Off-label use. Infusion rate should be reduced in patients with moderate to severe renal impairment.
- Body Weight
- 16-20 kg
- Dose
- 0.5 to 0.75 mg/kg bolus, followed by 1.0 to 1.75 mg/kg/hour infusion
- Frequency
- Continuous IV infusion
- Tracking Notes
- Off-label use. Ensure close monitoring of coagulation profile and vascular access sites for signs of bleeding.
| Body Weight | Dose | Frequency | Tracking Notes |
|---|---|---|---|
| Below 5 kg | Not routine | Continuous IV infusion (if prescribed) | Off-label use. Requires highly specialized pediatric cardiology or intensive care monitoring. Standard pediatric bolus is 0.5 to 0.75 mg/kg, followed by 1.0 to 1.75 mg/kg/hour infusion, titrated to clinical target coagulation levels. |
| 5-7 kg | 0.5 to 0.75 mg/kg bolus, followed by 1.0 to 1.75 mg/kg/hour infusion | Continuous IV infusion | Off-label use. Titrate infusion rate carefully based on ACT or aPTT monitoring. Monitor renal function closely. |
| 8-10 kg | 0.5 to 0.75 mg/kg bolus, followed by 1.0 to 1.75 mg/kg/hour infusion | Continuous IV infusion | Off-label use. Requires inpatient monitoring. Discontinue infusion immediately if severe, unexpected bleeding occurs. |
| 11-15 kg | 0.5 to 0.75 mg/kg bolus, followed by 1.0 to 1.75 mg/kg/hour infusion | Continuous IV infusion | Off-label use. Infusion rate should be reduced in patients with moderate to severe renal impairment. |
| 16-20 kg | 0.5 to 0.75 mg/kg bolus, followed by 1.0 to 1.75 mg/kg/hour infusion | Continuous IV infusion | Off-label use. Ensure close monitoring of coagulation profile and vascular access sites for signs of bleeding. |
Formulation
Purpose
Anticoagulant used to prevent blood clots during percutaneous coronary intervention (PCI), especially in patients with or at risk of heparin-induced thrombocytopenia (HIT).
Generic Name
BivalirudinBranded Drug Names
Bivalirudin is listed as a generic drug name. Common branded medicines that may contain the same active ingredient include:
Scheduled Drug
No. This medicine is generally not treated as a scheduled/prescription-only drug in common consumer references, but local rules may vary.