Bivalirudin
Bivalirudin dosing, mechanism of action, side effects, and clinical evidence. Complete reference for healthcare professionals.
MetabolicIntravenous0.75mg/kg bolus then 1.75mg/kg/hr infusion
Overview
Bivalirudin is a synthetic 20-amino acid peptide direct thrombin inhibitor derived from hirudin, used as an anticoagulant during PCI.
Mechanism of Action
- Direct thrombin inhibition — Binds both free and clot-bound thrombin
- Reversible — Thrombin slowly cleaves bivalirudin, restoring activity
- Predictable pharmacokinetics — Short half-life (~25 min)
Dosing
IV bolus 0.75mg/kg followed by infusion of 1.75mg/kg/hr during PCI.
Indications
FDA-approved for use as anticoagulant in patients undergoing PCI, with or without planned glycoprotein IIb/IIIa inhibitor.
Last updated: 2026-03-27