Bivalirudin
FDA ApprovedAlso known as: Angiomax, Angiox
AnticoagulantLast reviewed: April 28, 2026
A synthetic 20-amino acid peptide that directly inhibits thrombin. FDA-approved as an anticoagulant during percutaneous coronary intervention (PCI). Represents peptides' role in acute cardiovascular medicine.
Mechanism of Action
Directly and reversibly binds to both the catalytic site and anion-binding exosite of thrombin, inhibiting its ability to convert fibrinogen to fibrin. Unlike heparin, it does not require antithrombin III as a cofactor and can inhibit clot-bound thrombin.
Common Uses
- Anticoagulation during PCI
- Alternative to heparin in HIT patients
- Acute coronary syndromes
Known Risks
- Bleeding (primary risk)
- Back pain
- Nausea
- Hypotension
- No specific reversal agent (short half-life is the safety mechanism)
Regulatory Status
FDA-approved as Angiomax (2000) for use as an anticoagulant in patients undergoing PCI, including those with or at risk of heparin-induced thrombocytopenia (HIT). Generic available.
Common Protocols
Protocol information is for educational reference only. Dosing varies significantly by individual, condition, and physician guidance. Always work with a licensed healthcare provider.
Intravenous infusion
Typical Dose
0.75 mg/kg bolus + 1.75 mg/kg/hr infusion
Frequency
During PCI procedure only
Cycle Length
Single procedure
Hospital/cath lab use only. Short half-life (~25 min) provides rapid offset. Dose adjusted for renal impairment.
Research References
This information is for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before starting any peptide therapy. Data is compiled from published research and regulatory sources and may not reflect the most recent developments.