Drug interactions
Argatroban + Bivalirudin
Severity: Major
Argatroban and Bivalirudin: major interaction.
Last updated Sources: UK SmPC
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both are direct thrombin inhibitors, so using them together duplicates therapy and increases bleeding risk without added benefit.
What this interaction means in plain words
Argatroban and Bivalirudin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive pharmacodynamic direct thrombin inhibition.
What to do
Avoid concurrent use. Use one direct thrombin inhibitor and monitor aPTT or ACT and for bleeding when switching.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Argatroban
- Argatroban + Defibrotide Contraindicated
- Argatroban + Ketorolac Contraindicated
- Argatroban + Mifepristone Contraindicated
- Abciximab + Argatroban Major
- Acalabrutinib + Argatroban Major
- Acetylsalicylic acid + Argatroban Major
Frequently asked questions
Can I take Argatroban with Bivalirudin?
MediHelp rates the interaction as major. Argatroban and Bivalirudin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both are direct thrombin inhibitors, so using them together duplicates therapy and increases bleeding risk without added benefit.
How serious is the interaction between Argatroban and Bivalirudin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concurrent use. Use one direct thrombin inhibitor and monitor aPTT or ACT and for bleeding when switching.
What other medicines interact with Argatroban?
MediHelp also lists interactions of Argatroban with, for example, Defibrotide, Ketorolac, Mifepristone. The full list is on the Argatroban page.
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