Angiomax

Bivalirudin is a type of "blood thinner" used instead of heparin to prevent blood clots during certain procedures used to open up the blood vessels in the heart (e.g., balloon angioplasty, coronary stent placement, percutaneous coronary intervention-PCI). It is usually used with aspirin. Bivalirudin works by blocking a certain natural substance (thrombin) that the body uses to form blood clots. Blood clots can cause a heart attack or cause the opened blood vessel in the heart to close back up.

For the best possible benefit, it is important to receive each scheduled dose of this medication as directed. If you miss a dose, contact your doctor or pharmacist immediately to establish a new dosing schedule.

This medication is given by injection into a vein by a health care professional before your procedure. It is then given slowly into a vein until the procedure is over. It may be continued for 4 to 20 hours after your procedure or as directed by your doctor. The dosage is based on your weight, medical condition, and response to treatment. After your procedure, you will need to lie very still with your head up slightly. The tube for your procedure is usually placed near the groin. Keep the leg (or other limb nearest the tube) straight to prevent bleeding from the tube area. Pressure will be applied to the area (e.g., with a sandbag, special pressure dressing/device). You will not be allowed out of bed for several hours after the procedure.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval. Some products that may interact with this drug include: other "blood thinners" (e.g., warfarin), NSAIDs (e.g., ibuprofen, naproxen), anti-platelet drugs (e.g., dipyridamole, ticlopidine), tipranavir. Check all prescription and nonprescription medicine labels carefully since many contain pain relievers/fever reducers (NSAIDs such as ibuprofen, naproxen, or aspirin) that are similar to this drug. Bivalirudin is often used with other "blood thinners" such as aspirin and clopidogrel. Ask your doctor or pharmacist which medicines you need to take after leaving the hospital. Low-dose aspirin should be continued if prescribed by your doctor for heart attack or stroke prevention (usually at dosages of 81-325 milligrams a day). Consult your doctor or pharmacist for more details.

Laboratory and/or medical tests (e.g., bleeding times, complete blood count) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US National Poison Hotline at 1-800-222-1222. Canada residents can call a provincial poison control center.

Before using bivalirudin, tell your doctor or pharmacist if you are allergic to it; or to other hirudins (e.g., lepirudin); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: current bleeding. Before using this medication, tell your doctor or pharmacist your medical history, especially of: recent major surgery/injury/other bleeding, stomach/intestinal problems (e.g., peptic ulcer, inflammatory bowel disease), bleeding problems (e.g., anemia, coagulopathy, thrombocytopenia), kidney disease, liver disease, stroke, very high uncontrolled blood pressure, tumor/blood vessel problem in the brain (e.g., aneurysm, AV malformation). During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor. It is not known whether this drug passes into breast milk. Consult your doctor before breast-feeding.

Not applicable. This medication is given in a clinic and will not be stored at home.

Nausea, vomiting, heartburn, headache, or minor bleeding/irritation at the injection site may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Serious bleeding is the most common serious side effect. Tell your doctor immediately if any of these signs of serious bleeding occur: bleeding/bruising/swelling/oozing around the area where the procedure tube was placed, uncontrolled nosebleed, fast/irregular heartbeat, pale/gray/bluish skin, pink/red urine, bloody/black/tarry stool, coughing up blood, vomit that looks like coffee grounds. Get medical help right away if any of these signs of very serious bleeding occur: chest pain, vision problems, confusion, slurred speech, weakness on one side of the body. This medication may cause a decrease in blood platelets (thrombocytopenia). Tell your doctor immediately if you develop easy bleeding/bruising. A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.