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Bivalirudin Intravenous for Adults

Who can administer

Administration RESTRICTED - see Appendix 1

Important information

  • May be used only in Cardiothoracic surgery on Consultant advice
  • Unlicensed preparation in Ireland
  • IMPORTANT: The ACT is NOT the same as the APTT. Results are not interchangeable.

Available preparations

Bivalirudin 250mg vial

Reconstitution

Water for injection

  • Add 5mL per 250mg vial
  • Swirl gently until fully dissolved and the solution is clear
  • Reconstitution may take 3 to 4 minutes to be complete
  • Dilute further prior to administration
  • Take 5mL (250mg) of reconstitution solution and add to 45mL infusion fluid to produce a 5mg per mL solution- this diluted solution is used for both the bolus dose and the infusion (ref 1)

Infusion fluids

Glucose 5% or Sodium Chloride 0.9%

Methods of intravenous administration

Bolus intravenous injection (Cardiac surgery)

  • Administer required dose as a rapid IV push

Continuous intravenous infusion (Cardiac surgery)

  • Using a 5mg per ml solution (250mg in 50mL) - set up the continuous infusion
  • Adjust dose as per Q pulse document

Dose in adults

GUH: Only used in Cardiothoracic surgery

Monitoring

Storage

  • Store below 250C

References

1 Injectable Medicines guide, Medusa- downloaded Feb 7th, 2024

Therapeutic classification

Anticoagulant

IV Guide Type