What is the brand name for argatroban?

Acova (argatroban) dosing, indications, interactions, adverse effects, and more.

Why is argatroban used in HIT?

Argatroban is rapidly acting and has been shown to significantly reduce the risk of death or new thrombosis [Lewis et al. 2001]. Treatment of HIT with argatroban successfully lowers mortality rates from thrombosis without increased bleeding risk [Lewis et al. 2001].

What kind of drug is argatroban?

Argatroban is a medication used to manage heparin-induced thrombocytopenia (HIT), which is a rare, life-threatening complication of heparin therapy. It is a direct thrombin inhibitor, a class of anticoagulant drugs.

What is argatroban used for?

Argatroban is used to decrease the clotting ability of the blood and to help prevent harmful clots from forming in the blood vessels. This medicine is used to treat or prevent blood clots in patients with bleeding problems caused by another medicine called heparin.

Who manufactures argatroban?

Argatroban is a potent, reversible thrombin inhibitor initially developed by Mitsubishi Pharma Corporation (now Mitsubishi Tanabe Pharma Corporation). It is administered as a continuous intravenous infusion.

Where is argatroban from?

Argatroban is a synthetic direct thrombin inhibitor derived from L-arginine. This compound is a synthetic N2-substituted arginine derivative that binds to the catalytic site of thrombin with high affinity. It binds rapidly and reversibly to both clot-bound and soluble thrombin.

When do you stop argatroban for hits?

It is recommended that, at an INR >5, the argatroban infusion should be discontinued for 4 hours and the INR should be repeated.

What is the difference between argatroban and heparin?

Because argatroban does not resemble heparin, it does not cross-react with HIT antibodies,25 a disadvantage of low-molecular-weight heparin and danaparoid. Furthermore, being small and synthetic, argatroban does not induce formation of antibodies that can alter its clearance, a disadvantage of lepirudin.

What is the side effect of argatroban?

nausea, vomiting, diarrhea; low blood pressure; shortness of breath; headache, back pain; or.

When should argatroban be held?

Argatroban dosing and monitoring The APTT should be performed 2 hours after the initiation of infusion and after every dosage adjustment until the steady-state APTT is 1.5–3.0 times the initial baseline value.

What is argatroban made from?

Argatroban is a synthetic small molecule derived from l-arginine with specific antithrombotic activity. Argatroban is a direct thrombin inhibitor that binds avidly and reversibly to the catalytic site of thrombin and that does not require other cofactors to exert its antithrombotic action.

Who makes argatroban?

Newest addition to anticoagulant product portfolio Fresenius Kabi Argatroban is available in a 250mg/2.5mL presentation in a single dose vial and was approved by the FDA in March 2015.

What are the side effects of argatroban?

Common side effects of Argatroban injection include:

• nausea,
• vomiting,
• diarrhea,
• stomach pain,
• fever,
• headache,
• back pain, or.
• minor bleeding or irritation at the injection site.

How do you reverse argatroban?

Argatroban has a short half-life of around 45 minutes – stopping the infusion and initiating general measures should achieve reversal. There is a licensed antidote, idarucizumab, for rapid reversal of dabigatran for emergency surgery and procedures or in life-threatening or uncontrolled bleeding.

How often do you check PTT with argatroban?

Use Argatroban Anticoagulation Flow Sheet for documentation of rate and changes. Two RNs to perform independent calculations and document all dose changes on the Argatroban Flow Sheet. 2. Repeat PTT every 2 hours (4 hours for patients with impaired hepatic function or critically ill) until therapeutic x 2.

How much does argatroban cost?

A 10-day infusion of argatroban costs approximately $7,440, plus an estimated $800 in laboratory costs and the indirect cost of pharmacist supervision, which in sum costs at least $7,840 more than fondaparinux. The costs of different treatment options are particularly relevant when . . .

What medication is used to treat HIT?

Bivalirudin and fondaparinux have been used to treat HIT in small case series. New oral anticoagulants, such as factor IIa and factor Xa inhibitors, may provide a novel treatment approach in HIT. Summary: First-line therapies for HIT are argatroban or lepirudin.

When do you use PTT or anti-Xa?

For several years, most coagulation specialists have supported using the chromogenic anti-Xa assay in place of the PTT for monitoring unfractionated heparin therapy. We contend the anti-Xa is more accurate and reproducible as it is less prone to interference.

When do you use anti-Xa?

The anti-Xa Heparin Assay is commonly used to measure the anticoagulant effect of unfractionated heparin (UFH) using specific calibrators for heparin. The other most commonly used assay to manage heparin infusions is the activated partial thromboplastin time (aPTT).

How do you monitor Argatroban?

Argatroban is monitored using the activated partial thromboplastin time (aPTT). The goal aPTT in seconds has been defined at UWMC/HMC as 60-80 seconds. Alternatively, it can be monitored with the direct thrombin inhibitor assay available at UWMC/HMC.

Can you monitor argatroban with anti Xa?

1. When baseline aPTT is normal, argatroban can be monitored using the aPTT. 2. Argatroban infusion is typically titrated to achieve an aPTT that is 1.5 – 2.5x the patients’s baseline level.

What is argatroban drip?

Argatroban is a prescription medicine used to treat the symptoms of blood clots in adults (Thrombocytopenia) and Percutaneous Coronary Intervention. Argatroban may be used alone or with other medications.

Does Argatroban lower platelets?

Median baseline platelet counts were lower among argatroban-treated patients than control subjects. The mean (±SE) argatroban dose in the HIT and HITTS arm, respectively, was 2.0±0.1 μg · kg−1 · min−1 and 1.9±0.1 μg · kg−1 · min−1, and the duration of therapy was 5.3±0.3 days and 5.9±0.2 days, respectively.

How do you titrate argatroban?

Initial Dosage: Initiate an infusion of Argatroban Injection at 25 mcg/kg/min and administer a bolus of 350 mcg/kg via a large bore intravenous line over 3 to 5 minutes (see Table 2). Check an activated clotting time (ACT) 5 to 10 minutes after the bolus dose is completed.

What is the initial dose of argatroban?

Initial Dosage: Before administering Argatroban, discontinue heparin therapy and obtain a baseline activated partial thromboplastin time (aPTT). The recommended initial dose of Argatroban for adult patients without hepatic impairment is 2 mcg/kg/min, administered as a continuous infusion (see Table 1).

What is the clearance rate of argatroban in paediatric patients?

Paediatric patients: argatroban clearance is decreased in seriously ill paediatric patients. Based on population pharmacokinetic modeling, clearance in paediatric patients (0.17 L/hr/kg) was 50% lower compared to healthy adults (0.31 L/hr/kg).

What is a normal aPTT for argatroban?

An aPTT was drawn 2 hours after this dose reduction and the dose of Argatroban then was adjusted as clinically indicated (not to exceed 10 mcg/kg/min), to reach an aPTT between 1.5 and 3 times baseline value (not to exceed 100 seconds).

Hemorrhage can occur at any site in the body in patients receiving Argatroban in sodium chloride injection. An unexplained fall in hematocrit or hemoglobin or a fall in blood pressure may indicate hemorrhage. Intracranial and retroperitoneal hemorrhage [see Adverse Reactions (6.1)] have been reported.