Argatroban

Trade names

NOVASTAN

Actions

• Direct thrombin inhibitor

Route of Administration

Intravenous

Bioavailability

100%

Plasma protein binding

54%

Time to peak plasma concentration

1-3 h

Half-life

50 min

Duration of action

2–4 h

Metabolism

Hepatic

Enzymes involved

• No CYP involved.

Elimination

Biliary 65%, Renal 22%

Recommended dose

2 μg/kg/min given as continuous infusion. Activity is monitored by aPTT which should be 1.5 - 3.0 times the reference value. Small dose adjustments might be necessary to keep the aPTT within the therapeutic interval.

Indicated in patients with Heparin-induced thrombocytopenia in need of parenteral anticoagulation.

Renal impairment

No dose adjustment is necessary. Limited data exist on the usage of argatroban in patients on dialysis.

Hepatic impairment

In patients with moderate hepatic impairment (Child-Pugh class B) a reduction to 0.5 μg/kg/min is recommended.

Argatroban is contraindicated in patients with severe hepatic impairment.

Discontinuation before invasive procedures

Stop at least 4 hours before an invasive procedure.