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Hematology · FDA Approved

Bivalirudin (Angiomax)

FDA-approved

How to ask your doctor
Written by Peptide Association Editorial TeamLast reviewed Editorial policy

01 · Overview

A synthetic 20-amino acid peptide analog of hirudin that acts as a specific, reversible direct thrombin inhibitor, binding both fluid-phase and clot-bound thrombin (PMID 11929334). Bivalirudin provides more predictable anticoagulation than heparin (PMID 12064567).

As a direct thrombin inhibitor it does not need antithrombin as a cofactor and does not induce immune-mediated thrombocytopenia (PMID 18406993).

02 · Research summary & key findings

FDA-approved (Angiomax, 2000) as an anticoagulant for percutaneous coronary intervention (PCI), including in patients with or at risk of heparin-induced thrombocytopenia (HIT). In the HORIZONS-AMI trial of STEMI patients undergoing primary PCI, bivalirudin alone reduced 30-day major bleeding (4.9% vs. 8.3%) and all-cause death (2.1% vs. 3.1%) compared with heparin plus a GP IIb/IIIa inhibitor, but had a higher risk of acute stent thrombosis within 24 hours (PMID 18499566). In the ATBAT study of 52 HIT patients undergoing PCI, bivalirudin gave high procedural success with low major bleeding (PMID 14608128).

03 · Regulatory status

Bivalirudin (Angiomax) has received FDA approval and is available for clinical use under appropriate medical supervision. Consult a qualified healthcare provider for prescribing information.

Bivalirudin (Angiomax) is an FDA-approved medicine prescribed for the conditions on its label. It is not part of our intake, so we do not propose protocols for it. If you think it may be relevant to you, talk to your own doctor. How to ask your doctor.

04 · Administration routes

  • Intravenous

References

  1. [1]Bivalirudin: a review of its potential place in the management of acute coronary syndromes Drugs, 2002. PMID 11929334
  2. [2]Clinical pharmacology of bivalirudin Pharmacotherapy, 2002. PMID 12064567
  3. [3]The anticoagulant therapy with bivalirudin to assist in the performance of percutaneous coronary intervention in patients with heparin-induced thrombocytopenia (ATBAT) study: main results J Invasive Cardiol, 2003. PMID 14608128
  4. [4]New anticoagulant agents: direct thrombin inhibitors Cardiol Clin, 2008. PMID 18406993
  5. [5]Bivalirudin during primary PCI in acute myocardial infarction N Engl J Med, 2008. PMID 18499566

Primary literature

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Disclaimer: This information is provided for educational and research purposes only. It is not intended as medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before starting any peptide therapy. The Peptide Association does not endorse or recommend any specific treatment protocol. See our editorial policy for how this content is produced and reviewed. Clinicians: join the network.