Thrombolytics Argatroban

Concomitant use of argatroban with antiplatelet agents, thrombolytics, and other anticoagulants may increase the risk of bleeding (see Warnings). 

Argatroban as adjunctive therapy to thrombolytics in acute myocardial infarction... 

Table 3 Clinical trials of argatroban in acute myocardial infarction with thrombolytics ...

Low-dose aspirin did not alter the pharmacokinetics or pharmacodynamic effects of ai atroban. Neither abciximab nor eptifibatide appeared to alter ai atroban pharmacokinetics. There is no pharmacodynamic interaction between bivalirudin and aspirin, ticlopidine, ciopidogrei, abciximab, eptifibatide or tirofiban. Nevertheless, the manufacturers warn of the increased bleeding risks if argatroban, bivalirudin or lepirudin are used with antiplatelet drugs or thrombolytics. 

Thrombolytics. The manufacturer notes that, in patients with acute myocardial infarction, the incidence of intracranial bleeding was 1% (8 out of 810 patients) in patients receiving both argatroban and thrombolytic therapy (streptokinase or alteplase). They therefore state that the s ety and effectiveness of argatroban with thrombolytics has not been established, and that concurrent use may increase the risk of bleeding. ... 

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