Alternative parenteral anticoagulants for patients with heparin-induced thrombocytopenia (HIT).
| . | Lepirudin (Refludan®) . | Argatroban (Novastan®) . | Danaparoid (Orgaran®) . | Bivalirudin (AngiomaxTM) . |
|---|---|---|---|---|
| Abbreviations include: ATIII, antithrombin III; IV, intravenous; SQ, subcutaneous; ECT, ecarin clotting time; ACT, activated clotting time; HIT, heparin-induced thrombocytopenia; PCI, percutaneous coronary intervention. | ||||
| Mechanism of action: | Direct thrombin inhibitor | Direct thrombin inhibitor | ATIII-dependent inactivation of factor Xa and thrombin | Direct thrombin inhibitor |
| Half-life: | 1.5 hr | 40 min | 19 hr | 25 min |
| Route of administration: | IV or SQ | IV | IV or SQ | IV |
| Elimination: | Renal | Hepatic | Renal | Renal |
| Monitoring: | aPTT or ECT | aPTT | Anti-factor Xa assay | ACT or aPTT |
| Effect on INR: | Prolonged | Prolonged | None | Prolonged |
| FDA-approved indication: | HIT | HIT | Thromboprophylaxis for orthopedic patients | PCI |
| . | Lepirudin (Refludan®) . | Argatroban (Novastan®) . | Danaparoid (Orgaran®) . | Bivalirudin (AngiomaxTM) . |
|---|---|---|---|---|
| Abbreviations include: ATIII, antithrombin III; IV, intravenous; SQ, subcutaneous; ECT, ecarin clotting time; ACT, activated clotting time; HIT, heparin-induced thrombocytopenia; PCI, percutaneous coronary intervention. | ||||
| Mechanism of action: | Direct thrombin inhibitor | Direct thrombin inhibitor | ATIII-dependent inactivation of factor Xa and thrombin | Direct thrombin inhibitor |
| Half-life: | 1.5 hr | 40 min | 19 hr | 25 min |
| Route of administration: | IV or SQ | IV | IV or SQ | IV |
| Elimination: | Renal | Hepatic | Renal | Renal |
| Monitoring: | aPTT or ECT | aPTT | Anti-factor Xa assay | ACT or aPTT |
| Effect on INR: | Prolonged | Prolonged | None | Prolonged |
| FDA-approved indication: | HIT | HIT | Thromboprophylaxis for orthopedic patients | PCI |