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Argatroban

    Brands

    DEA Class; Rx

    Common Brand Names; Acova

    • Anticoagulants, Cardiovascular; 
    • Anticoagulants, Hematologic; 
    • Thrombin Inhibitor

    Intravenous, direct thrombin inhibitor
    Used for thrombosis prophylaxis or treatment in patients with heparin-induced thrombocytopenia (HIT) and as an anticoagulant in patients with or at risk of HIT undergoing percutaneous coronary intervention (PCI)
    Hepatically eliminated, can use in end-stage renal disease without dosage adjustment

    Indicated for use as an anticoagulant in the treatment of thrombosis (i.e., deep venous thrombosis (DVT), pulmonary embolism) or for venous thromboembolism (VTE) prophylaxis (i.e., deep venous thrombosis (DVT) prophylaxis, pulmonary embolism prophylaxis) in patients with heparin-induced thrombocytopenia (HIT).

    For coronary artery thrombosis prophylaxis or treatment during percutaneous coronary intervention (PCI) in patients who have or who are at risk of developing heparin-induced thrombocytopenia.
    For use as adjunctive therapy to thrombolytic agents in the treatment of ST-elevation myocardial infarction (STEMI) (i.e., acute myocardial infarction).
    For the treatment of disseminated intravascular coagulation (DIC).

    Hypersensitivity

    Active major bleeding

    GI bleeding (14%)

    Hematuria (12%)

    Chest pain (1-15%)

    Hemoglobin and hematocrit decrease (10%)

    Hypotension (7-10%)

    Dyspnea (8%)

    Fever (7%)

    Sepsis (6%)

    Cardiac arrest (6%)

    Diarrhea (6%)

    Nausea (5%)

    Groin hemorrhage (5%)

    Pain (5%)

    Urinary tract infection (5%)

    Ventricular tachycardia (5%)

    Bradyarrhythmia (4.5%)

    Infection (4%)

    Vomiting (2.6-4%)

    Intracranial hemorrhage (1-4%)

    Myocardial infarction (3.5%)

    Hemoptysis (3%)

    Nephrotoxicity (3%)

    Cough (3%)

    Atrial fibrillation (3%)

    Brachial hemorrhage (2%)

    Major GI hemorrhage (1-2%)

    Angina (1.8%)

    Coronary arterial hemorrhage (1.8%)

    Coronary artery thrombosis (1.8%)

    Monitor therapy with aPTT

    Use caution in hepatic impairment; achievement of steady-state aPTT levels may take longer and require more argatroban dose adjustments in patients with hepatic impairment compared to patients with normal hepatic function; avoid use of high doses in patients undergoing percutaneous coronary intervention (PCI) who have clinically significant hepatic disease

    Patients with illnesses that reduce clearance may require dose reduction

    Safety and efficacy of concomitant administration with thrombolytic agents not established

    Discontinue parenteral anticoagulant therapy prior to initiating treatment

    Limited data from published literature and postmarketing reports do not suggest an association between argatroban and adverse fetal developmental outcomes; there are risks to mother associated with untreated thrombosis in pregnancy and a risk of hemorrhage in mother and fetus associated with use of anticoagulants

    There are no data on presence in human milk, or effects on milk production; it is present in rat milk; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed infant from therapy or from underlying maternal condition

    The maximum dosage is individualized based on aPTT or ACT monitoring and assessment of efficacy and safety parameters.

    Argatroban

    injectable solution

    • 100mg/mL

    ready-to-use injectable

    • 50mg/50mL 0.9% NaCl
    • 125mg/125mL 0.9% NaCl
    • 250mg/2.5mL 0.9% NaCl