DDInter217 DDInter856
Bivalirudin is a synthetic 20 residue peptide (thrombin inhibitor) which reversibly inhibits thrombin. Once bound to the active site, thrombin cannot activate fibrinogen into fibrin, the crucial step in the formation of thrombus. It is administered intravenously. Because it can cause blood stagnation, it is important to monitor changes in hematocrit, activated partial thromboplastin time, international normalized ratio and blood pressure.
Unfractionated heparin (UH) is a heterogenous preparation of anionic, sulfated glycosaminoglycan polymers with weights ranging from 3000 to 30,000 Da. It is a naturally occurring anticoagulant released from mast cells. It binds reversibly to antithrombin III (ATIII) and greatly accelerates the rate at which ATIII inactivates coagulation enzymes thrombin (factor IIa) and factor Xa. UH is different from low molecular weight heparin (LMWH) in the following ways: the average molecular weight of LMWH is about 4.5 kDa whereas it is 15 kDa for UH; UH requires continuous infusions; activated partial prothrombin time (aPTT) monitoring is required when using UH; and UH has a higher risk of bleeding and higher risk of osteoporosis in long term use. Unfractionated heparin is more specific than LMWH for thrombin. Furthermore, the effects of UH can typically be reversed by using protamine sulfate.
Bivalirudin {u} may cause a minor interaction that can limit clinical effects when taken with {v} Clove
Bivalirudin {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Oxaprozin
Bivalirudin {u} may lead to a major life threatening interaction when taken with {v} Reteplase
Bivalirudin {u} may lead to a major life threatening interaction when taken with {v} Lepirudin
Bivalirudin may cause a minor interaction that can limit clinical effects when taken with Clove
Bivalirudin may cause a moderate interaction that could exacerbate diseases when taken with Oxaprozin
Bivalirudin may lead to a major life threatening interaction when taken with Reteplase
Bivalirudin may lead to a major life threatening interaction when taken with Lepirudin