Drug interactions
Bivalirudin + Heparin
Severity: Major
Bivalirudin and Heparin: major interaction.
Last updated Sources: US FDA label
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 drugs are anticoagulants, and combined use raises bleeding risk. Heparin can also prolong clotting times used to monitor bivalirudin.
What this interaction means in plain words
Bivalirudin and Heparin 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 anticoagulation via antithrombin-dependent and direct thrombin inhibition.
What to do
Avoid overlap except when planned, such as during PCI protocols. Monitor ACT or aPTT and bleeding.
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 Heparin
- Defibrotide + Heparin Contraindicated
- Heparin + Ketorolac Contraindicated
- Heparin + Oritavancin Contraindicated
- Acemetacin + Heparin Major
- Acetylsalicylic acid + Heparin Major
- Alteplase + Heparin Major
Frequently asked questions
Can I take Bivalirudin with Heparin?
MediHelp rates the interaction as major. Bivalirudin and Heparin 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 drugs are anticoagulants, and combined use raises bleeding risk. Heparin can also prolong clotting times used to monitor bivalirudin.
How serious is the interaction between Bivalirudin and Heparin?
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 overlap except when planned, such as during PCI protocols. Monitor ACT or aPTT and bleeding.
What other medicines interact with Heparin?
MediHelp also lists interactions of Heparin with, for example, Defibrotide, Ketorolac, Oritavancin. The full list is on the Heparin page.
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