argatroban (Novastan)

^[1]^[2]^[3]

Indications

(administration)

given intravenously as continuous infusion
heparin-induced thrombocytopenia:
- adult patients without hepatic impairment is 2 ug/kg/min
PCI in HIT/HITTS patients
- bolus of 350 mcg/kg over 3-5 minutes via large bore IV
- then 25 ug/kg/min infusion ,Available in 250-mg (in 2.5-mL) single-use amber vials. Inert ingredients: 750 mg D-sorbitol, 1,000 mg dehydrated alcohol. Dilute contents 100-fold, i.e. each 2.5-mL vial should be diluted by mixing with 250 mL of diluent, pH of intravenous solution prepared as recommended is 3.2 to 7.5 Store the vials in original cartons at room temperature

heparin-induced thrombocytopenia:
- monitor aPTT
  - steady-state levels within 1-3 hours following initiation of argatroban
PCI in HIT/HITTS patients
- activated clotting time (ACT), 300-450 sec is therapeutic
- should be checked 5-10 minutes after the bolus dose
- procedure may proceed if the ACT is > 300 seconds
- if the ACT is < 300 seconds, an additional IV bolus dose of 150 ug/kg should be administered, the infusion dose increased to 30 ug/kg/min, & the ACT checked 5-10 minutes later (see Table 9)
- if the ACT is > 450 seconds, the infusion rate should be decreased to 15 ug/kg/min, & the ACT checked 5-10 minutes later
- maintain infusion rate throughout procedure if ACT is therapeutic
argatroban in plasma

Manufactured by GlaxoSmithKline

↑ ^1.0 ^1.1 Medical Knowledge Self Assessment Program (MKSAP) 11, 17. American College of Physicians, Philadelphia 1998, 2015
↑ Prescriber's Letter 8(2):supplement 2001
↑ Di Nisio M et al Direct thrombin inhibitors. N Engl J Med 2005;353:1028-40 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16148288