PEPTIDESTAT
ApprovedClinical / approved drugIntravenousEvidence 4/5

Bivalirudin

Also known as: Angiomax, Angiox

Bivalirudin is a bivalent direct thrombin inhibitor that reversibly binds both the catalytic active site and the anion-binding exosite of circulating and clot-bound thrombin to block fibrin formation.

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Bivalirudin
Drug class
Direct thrombin inhibitor (parenteral anticoagulant; hirudin-derived peptide)
Primary targets
Thrombin (active catalytic site), Thrombin anion-binding exosite (exosite 1)
Dose reference
Per the Angiomax FDA label (not a recommendation): IV bolus 0.75 mg/kg followed by 1.75 mg/kg/h infusion for the duration of PCI, with a 0.3 mg/kg supplemental bolus if needed and infusion reduced in renal impairment/dialysis.
Half-life
About 25 minutes with normal renal function; roughly 34-57 minutes in renal impairment and about 3.5 hours in dialysis-dependent patients (Angiomax label).
Developer / origin
The Medicines Company (originally developed as Hirulog/bivalirudin)
Reference year
2000
Evidence score
4/5 - Approved with supportive randomized trial evidence

Approved uses

  • Anticoagulant for patients undergoing percutaneous coronary intervention (PCI)
  • Patients with, or at risk of, heparin-induced thrombocytopenia and thrombosis syndrome (HIT/HITTS) undergoing PCI
Evidence 4/5

Approved with supportive randomized trial evidence

Bivalirudin is FDA-approved as a procedural anticoagulant for PCI, supported by large randomized trials (BAT, HORIZONS-AMI and later PCI studies) and a detailed prescribing label; its benefit is comparator-dependent and it carries a documented acute stent thrombosis signal in STEMI.

Investigational compound with human randomized or phase 2/3 evidence.

Evidence basis

  • FDA-approved Angiomax prescribing information defines indication, dosing, mechanism, pharmacokinetics and warnings
  • BAT trial (>4,000 patients) compared bivalirudin to heparin during angioplasty for unstable/postinfarction angina
  • HORIZONS-AMI and subsequent PCI trials evaluated bivalirudin versus heparin plus glycoprotein IIb/IIIa inhibitors
  • Pharmacology reviews characterize the bivalent, reversible direct thrombin inhibition mechanism

How to read this entry

Dose references and half-life values are pulled from trial protocols, labels, reviews, or published summaries where available. They are context for research and comparison, not a personal dosing recommendation.

Status matters: approved drugs have regulated indications; investigational compounds are still being studied; research-only peptides do not have established human dosing, safety, or efficacy for consumer use.

Bivalirudin guides

Read the matching guide or adjacent research pages for more context.

Bivalirudin Peptide: Angiomax Direct Thrombin Inhibitor GuideBivalirudin is an FDA-approved, hirudin-derived bivalent direct thrombin inhibitor used as a short-acting intravenous anticoagulant during percutaneous coronary intervention.Abaloparatide Peptide: Tymlos, PTHrP Analog Uses and Safety LimitsAbaloparatide is an FDA-approved PTHrP(1-34) analog peptide that builds bone in high-risk osteoporosis, backed by the ACTIVE and ATOM trials with clear duration and safety limits.Atosiban Peptide: Tractocile, Oxytocin Antagonist Tocolytic for Preterm LaborAtosiban is an EU-approved oxytocin and vasopressin receptor antagonist peptide used intravenously as a short-term tocolytic to delay preterm labor.Calcitonin Peptide: Miacalcin, Fortical, Uses and Safety LimitsCalcitonin is an approved calcitonin-receptor agonist peptide with label-backed bone uses, modest evidence and a malignancy-signal caution that shapes its modern role.

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