From the Guidelines
The half-life of bivalirudin is approximately 25 minutes after IV injection, as reported in the 2012 American College of Chest Physicians evidence-based clinical practice guidelines 1. This short half-life is a significant factor in the clinical use of bivalirudin, particularly in procedures where rapid reversal of anticoagulation may be necessary.
- The pharmacokinetics of bivalirudin are characterized by a rapid clearance, with only 20% of the drug being excreted via the kidneys 1.
- The majority of bivalirudin is eliminated through proteolytic cleavage, which allows for a relatively consistent half-life in patients with normal renal function.
- However, it is essential to consider the potential impact of renal impairment on the half-life of bivalirudin, as dose reduction may be necessary in patients with moderate to severe renal impairment 1.
- The clinical benefits of bivalirudin's short half-life include the ability to quickly reverse anticoagulation effects after discontinuation, which can be advantageous in situations requiring rapid restoration of normal coagulation, such as urgent surgery or bleeding complications.
- In clinical practice, the use of bivalirudin should be guided by its pharmacokinetic properties, including its half-life, to ensure optimal patient outcomes and minimize the risk of adverse events 1.
From the FDA Drug Label
Bivalirudin has a half-life of 25 minutes in PTCA patients with normal renal function. The half-life of bivalirudin (Bivalirudin, Angiomax) is 25 minutes in patients with normal renal function 2.
- In patients with moderate renal impairment, the half-life is 34 minutes.
- In patients with severe renal impairment, the half-life is 57 minutes.
- In dialysis patients, the half-life is 3.5 hours.
From the Research
Half-Life of Bivalirudin
- The half-life of bivalirudin is approximately 25 minutes, as stated in the study published in 2008 3.
- Another study published in 2023 also reports a half-life of ~25 min for bivalirudin 4.
- A study from 2011 found the half-life of bivalirudin to be approximately 0.57 h (34 min) in healthy Chinese subjects 5.
- Additionally, a 2008 study reported a half-life of approximately 25 to 30 minutes for bivalirudin 6.
Variability in Half-Life
- The half-life of bivalirudin may vary slightly depending on the population being studied and the methods used to determine the half-life, as seen in the studies cited above 3, 4, 5, 6.
- However, overall, the half-life of bivalirudin is consistently reported to be around 25 minutes, indicating a relatively short duration of action 3, 4.
Factors Affecting Half-Life
- The elimination half-life of bivalirudin can be affected by modified ultrafiltration strategies after cardiopulmonary bypass, as demonstrated in a 2008 study 6.
- Hemofiltration with a constant flow and a filtrate volume of 3000 mL can reduce the elimination half-life of bivalirudin, while adding dialysis to hemofiltration can also reduce the half-life and postoperative blood loss 6.