From the Guidelines
Bivaleiduin is not a recognized medical term, and it appears to be a misspelling or variation of the actual medication "Bivalirudin". Given the context, it seems that the question is actually referring to Bivalirudin, a synthetic polypeptide and an analog of hirudin, used as an anticoagulant in patients undergoing percutaneous interventions for unstable angina or non-ST-elevation or ST-elevation myocardial infarction and in patients with heparin-induced thrombocytopenia (HIT) who require percutaneous coronary interventions 1. The recommended dose of Bivalirudin is a bolus of 0.75 mg/kg followed by an infusion of 1.75 mg/kg/h for the duration of the procedure, with dose reduction considered in patients with moderate to severe renal impairment 1. Some studies have compared Bivalirudin with heparin in patients undergoing urgent or elective PCI, showing that Bivalirudin has a significantly lower bleeding rate and similar mortality rates compared to heparin 1. Key points about Bivalirudin include:
- It is a synthetic polypeptide and an analog of hirudin
- It is used as an anticoagulant in specific patient populations
- The recommended dose is a bolus of 0.75 mg/kg followed by an infusion of 1.75 mg/kg/h
- Dose reduction should be considered in patients with moderate to severe renal impairment
- It has been shown to have a lower bleeding rate compared to heparin in some studies. If you're seeking information about a specific medication or medical concept, I would recommend consulting with a healthcare professional who can provide accurate information about established medical treatments or concepts. Without additional context about what you're trying to learn about, I cannot provide specific dosing, regimens, or scientific reasoning for something that doesn't exist in medical practice. If you're looking for information about a particular health concern or medication, providing the correct terminology would allow for a more helpful and accurate response.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Bivalirudin Overview
- Bivalirudin is a direct thrombin inhibitor used in percutaneous coronary interventions (PCI) [ 2, 3, 4, 5, 6 ].
- It has been shown to reduce adverse bleeding events compared to unfractionated heparin in patients undergoing PCI [ 2, 3 ].
Safety and Efficacy
- The safety and efficacy of bivalirudin in patients with abnormal renal function have been assessed, with results indicating that patients with decreased renal function are at a higher risk for in-hospital complications [ 2 ].
- Bivalirudin has been found to be a viable alternative to the use of a heparin combined with a glycoprotein IIb/IIIa inhibitor in PCI [ 3, 4 ].
- However, the antithrombotic efficacy of bivalirudin compared to unfractionated heparin during PCI for acute coronary syndrome has been questioned, with some studies suggesting that bivalirudin may be associated with an increased risk of acute stent thrombosis [ 6 ].
Pharmacology and Pharmacokinetics
- Bivalirudin is a 20 amino acid polypeptide hirudin analog that reversibly binds to thrombin's catalytic site and substrate recognition site, blocking both circulating and fibrin-bound thrombin [ 3, 4 ].
- It has a short half-life of approximately 25 minutes and is primarily eliminated renally, with dosage reduction required in patients with severe renal dysfunction [ 3 ].
Clinical Trials and Guidelines
- Clinical trials have demonstrated that bivalirudin is at least as effective as unfractionated heparin in preventing ischemic complications in PCI [ 3 ].
- The use of bivalirudin in acute coronary syndromes is supported by current guidelines, although the evidence derives mostly from early randomized trials [ 5 ].
- New data and ongoing trials continue to shape the understanding of bivalirudin's role in PCI and acute coronary syndromes [ 5, 6 ].