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

• See guideline here

Monitoring

• See guideline

Storage

• Store below 25⁰C

References

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

 

SPC (US product)

Therapeutic classification

Anticoagulant