Miscellaneous hematological agents:
Indications for ARGATROBAN:
Prophylaxis and treatment of thrombosis in adults with heparin-induced thrombocytopenia (HIT). Anticoagulation in adults with or at risk of HIT undergoing percutaneous coronary intervention (PCI).
Give by IV infusion. HIT: discontinue heparin and obtain baseline aPTT. Initially 2mcg/kg/min; check aPTT 2hrs after starting; titrate to 1.5–3x baseline aPTT (max 100secs); max 10mcg/kg/min. PCI: give 350mcg/kg bolus by large bore IV line over 3–5mins, then initiate infusion of 25mcg/kg/min. Check ACT 5–10mins after bolus; titrate based on activated clotting time (ACT) to therapeutic ACT of 300–450secs (see full labeling). Hepatic impairment: reduce dose and titrate carefully; see full labeling. Conversion to oral anticoagulants: see full labeling.
Increased bleeding risk (eg, severe hypertension, recent lumbar puncture, spinal anesthesia, major surgery, bleeding disorders, GI lesions). Hepatic impairment. PCI: avoid high doses in significant hepatic disease or AST/ALT ≥3x ULN. Labor & delivery. Pregnancy. Nursing mothers.
Direct thrombin inhibitor.
Increased risk of bleeding with concomitant thrombolytics, warfarin, heparin, antiplatelets, GP IIb/IIIa blockers.
Bleeding, dyspnea, hypotension, fever, diarrhea, sepsis, cardiac arrest, chest pain, back pain, nausea, vomiting, headache.