Bivalirudin pharmacokinetics

Bivalirudin Pharmacokinetic Parameters and Dose Adjustments in Renal Impairment ... 

Robson, R. White, H. Aylward, P. Frampton, C. Bivalirudin pharmacokinetics and phsirmacodynamics effect of renal function, dose, and gender, Clin.Pharmacol.Ther., 2002, 71, 433-439. 

Pharmacokinetics The plasma half-life of intravenous bivalirudin is 25 minutes but increases with decreasing glomerular filtration rate. According to the manufacturer, the total body clearance of bivalirudin is 3.4ml/min per kg but decreases with decreasing renal function. 

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. 

Use of argatroban with warfarin and related oral anticoagulants has an effect on the measurement of the BVR, and the manufacturer provides equations to adjust for this. Argatroban does not alter warfarin pharmacokinetics. The manufacturers warn of the increased bleeding risks if aigatroban, bivalirudin or lepirudin are used with other anticoagulants. 

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