Canterbury DHB

Context

Management of HIT

In This Section

Bivalirudin therapy

Dose modifications of the Bivalirudin dosage regimen

Patients scheduled for a switch to oral anticoagulation

Bivalirudin therapy

Initial dosage

Anticoagulation in adult patients with HIT type II and thromboembolic disease:

Note: the bolus dose and infusion rate must be reduced in case of known or suspected renal insufficiency (creatinine clearance below 30 mL/min, see below).

Normally, the dosage depends on the patient's body weight. This is valid up to a body weight of 110 kg. In patients with a body weight exceeding 110 kg the dosage should not be increased beyond the 110 kg body weight dose.

Monitoring of the Bivalirudin dosage regimen - standard recommendations

Dose modifications of the Bivalirudin dosage regimen

Recommendations for use in patients with renal impairment

  1. In haemodialysis patients or in case of acute renal failure (creatinine clearance below 15 mL/min or creatinine value above 530 mcmol/L), infusion of Bivalirudin is to be avoided or stopped.

    Only if aPTT values have fallen below the lower therapeutic limit (see Monitoring: target range), further intravenous bolus doses of 0.1 mg/kg body weight may be considered every other day.

Patients scheduled for a switch to oral anticoagulation

Recommendation:

About this Canterbury DHB document (5191):

Document Owner:

Mark Smith (see Who's Who)

Issue Date:

August 2016

Next Review:

August 2018

Keywords:

Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document. Disclaimer

Topic Code: 5191