bivalirudin

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Pronunciation: bye VAL i roo din

Brand: Angiomax

What is the most important information I should know about bivalirudin?

You should not receive bivalirudin if you are allergic to it, or if you have any major bleeding from a surgery, injury, or other medical trauma.

Tell your doctor if you are using blood thinners or receiving any other medications to treat or prevent blood clots.

Bivalirudin can make it easier for you to bleed even from a minor injury.

What is bivalirudin?

Bivalirudin is an anticoagulant (thrombin inhibitor) that helps prevent the formation of blood clots. An unwanted blood clot can occur with certain heart or blood vessel conditions.

Bivalirudin is used to prevent blood clots in people with severe chest pain or other conditions who are undergoing a procedure called angioplasty (to open blocked arteries).

Bivalirudin may also be used for purposes not listed in this medication guide.

What should I discuss with my health care provider before receiving bivalirudin?

You should not receive bivalirudin if you are allergic to bivalirudin, or if you have any major bleeding from a surgery, injury, or other medical trauma.

To make sure bivalirudin is safe for you, tell your doctor if you have:

  • heart disease;
  • kidney disease;
  • a bleeding or blood clotting disorder, such as hemophilia; or
  • if you use a blood thinner (warfarin, Coumadin, Jantoven) and you have routine "INR" or prothrombin time tests.

Tell your doctor if you are pregnant or plan to become pregnant.

Bivalirudin is not expected to be harmful to an unborn baby. However, aspirin is sometimes given with bivalirudin, and taking aspirin during late pregnancy may cause bleeding in the mother or the baby during delivery.

Tell your doctor if you are pregnant before you are treated with bivalirudin and aspirin.

It is not known whether bivalirudin passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How is bivalirudin given?

Bivalirudin is injected into a vein through an IV. You will receive this injection during your angioplasty procedure in a clinic or hospital setting. The medicine must be given throughout the entire procedure.

Your doctor may want you to continue receiving bivalirudin for up to 20 hours after your angioplasty procedure.

Bivalirudin is usually given together with aspirin.

Because bivalirudin keeps your blood from coagulating (clotting) to prevent unwanted blood clots, it may be easier for you to bleed even from a minor injury. Contact your doctor or seek emergency medical attention if you have bleeding that will not stop.

What happens if I miss a dose?

Because you will receive bivalirudin in a clinical setting, you are not likely to miss a dose.

What happens if I overdose?

Since this medication is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

What should I avoid after receiving bivalirudin?

Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.

Avoid drinking alcohol. It may increase your risk of bleeding in your stomach or intestines.

What are the possible side effects of bivalirudin?

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Tell your caregivers right away if you have:

  • a light-headed feeling, like you might pass out;
  • easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;
  • any bleeding that will not stop;
  • slow heartbeats;
  • little or no urinating;
  • signs of stomach bleeding --bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;
  • signs of a stroke --sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech, problems with vision or balance;
  • signs of a blood clot in the lung --chest pain, sudden cough, wheezing, rapid breathing;
  • signs of a blood clot in your leg --pain, swelling, warmth, or redness in one or both legs; or
  • increased blood pressure --severe headache, blurred vision, pounding in your neck or ears.

Common side effects may include:

  • headache, anxiety;
  • nausea, vomiting;
  • pelvic pain, back pain;
  • sleep problems (insomnia); or
  • pain or irritation where the injection was given.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect bivalirudin?

Tell your doctor about all your current medicines and any you start or stop using, especially medications to treat or prevent blood clots, such as:

  • heparin, warfarin (Coumadin, Jantoven);
  • argatroban, dabigatran, fondaparinux, lepirudin, rivaroxaban;
  • abciximab, eptifibatide, tirofiban;
  • dalteparin, enoxaparin, tinzaparin;
  • anagrelide, cilostazol, clopidogrel, dipyridamole, eltrombopag, oprelvekin, prasugrel, romiplostim, ticagrelor, ticlopidine; or
  • alteplase, reteplase, tenecteplase, urokinase.

This list is not complete. Other drugs may interact with bivalirudin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

Your doctor or pharmacist can provide more information about bivalirudin.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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