Monograph Details
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Hematology
> Thromboembolic disorders
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ARGATROBAN |
| Manufacturer |
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GlaxoSmithKline Pharmaceuticals |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Anticoagulant (thrombin inhibitor). |
| Generic Name |
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Argatroban 100mg/mL; soln for IV infusion after dilution. |
| Indications |
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Prophylaxis and treatment of thrombosis in heparin-induced thrombocytopenia (HIT) or in those with or at risk of HIT undergoing percutaneous coronary intervention (PCI). |
| Children |
<18yrs: not recommended.
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| Adults |
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≥18yrs: HIT: Discontinue heparin and obtain baseline aPTT. Initially 2micrograms/kg per minute by continuous IV infusion; check aPTT 2 hrs after starting; titrate to 1.5–3x baseline aPTT (max 100seconds); max 10micrograms/kg per minute. PCI: initially 25micrograms/kg per minute by IV infusion, and 350micrograms/kg bolus by large bore IV line over 3–5minutes; titrate based on activated clotting time (ACT) to therapeutic ACT of 300–450seconds. For both: hepatic impairment: reduce dose (see literature). |
| Contraindications |
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Overt major bleeding. Concomitant other parenteral anticoagulants. |
| Precautions |
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Increased bleeding risk (eg, unexpected decreases in hematocrit or BP, severe hypertension, recent lumbar puncture, spinal anesthesia, major surgery, bleeding disorders, GI lesions). Pregnancy (Cat.B). Nursing mothers: not recommended. |
| Interactions |
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Increased risk of bleeding with thrombolytics (eg, t-PA, streptokinase), Vit. K antagonists (eg, warfarin), heparin, antiplatelets, GP IIb/IIIa blockers (eg, eptifibatide). |
| Adverse Reactions |
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Hemorrhagic events, chest pain, dyspnea, cough, hypotension, rash, fever, GI upset, cardiac arrest, ventricular tachycardia, others. |
| How Supplied |
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Single-use vial (2.5mL)—1 |
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