Argatroban
Administration
- Type: Anticoagulant (Direct thrombin inhibitor)
- Dosage Forms: injectable solution, ready-to-use injectable
- Dosage Strengths: injectable solution: 100mg/mL; ready-to-use injectable: 50mg/50mL 0.9% NaCl, 125mg/125mL 0.9% NaCl
- Routes of Administration: IV
- Common Trade Names: Acova
Adult Dosing
- HIT with thrombosis: 2 mcg/kg/min IV infusion, titrate to aPTT 1.5-3x baseline value
- Myocardial infarction: 100 mcg/kg IV bolus + 1-3mcg/kg/min IV infusion x 6-72 hours; goal aPTT 50-85 seconds
- Cerebral thrombosis: 60 mg/day continuous IV infusion x 2 days, then 10mg IV BID x 5 days
- Coronary thrombosis prophylaxis after PCI (in patients at risk for HIT): 350 mcg/kg IV bolus + 25 mcg/kg/min IV continuous infusion; titrate to maintain activated clotting time 300-450 seconds
Pediatric Dosing
Safety/efficacy not established
- HIT: 0.75 mcg/kg/min IV infusion; titrate in increments of 0.1-0.25 mcg/kg/min to goal aPTT 1.5-3x baseline level
Special Populations
- Pregnancy Rating: B
- Lactation risk: Infant risk cannot be ruled out
- Renal dosing: no adjustment
- Hepatic dosing: more frequent dosage adjustments may be needed. For HIT treatment in moderate-severe liver disease, initial dose 0.5mcg/kg/min
Contraindications
- Allergy to class/drug
- Major bleeding
Adverse Reactions
Serious
- Major bleeding: GI bleeding, retroperitoneal hemorrhage, intracranial hemorrhage, coronary artery hemorrhage, hematuria
- Angina, coronary artery thrombosis, aortic valve stenosis, MI, cardiac arrest
- Sepsis
- Pulmonary edema
Common
- Hypotension
- Chest pain
- Nausea/vomiting, diarrhea
- Headache, backache
- Dyspnea
- Fever
Pharmacology
- Half-life: 30-51min, prolonged in hepatic impairment
- Metabolism: Hepatic
- Excretion: Mostly fecal
Mechanism of Action
- Binds to and directly inhibits thrombin