Argatroban Antithrombin Anticoagulant
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About Heparin-Induced Thrombocytopenia (HIT)

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Pharmacy Case Presentation

Argatroban is an ideal anticoagulant in heparin-induced thrombocytopenia
In healthy subjects anticoagulant effects begin immediately upon infusion. In most patients, therapeutic aPTT levels are achieved within 3 hours. Argatroban Injection is a synthetic direct thrombin inhibitor that does not interact with heparin antibodies. Argatroban is an important treatment for the devastating HIT drug reaction.

The Benefits of Argatroban[2]

Significantly improved clinical outcomes as compared to historical controls (composite of death, amputation, or new thrombosis).
Convenient monitoring with aPTT
Therapeutic aPTT levels are achieved in most patients within 3 hours
In healthy subjects:
Anticoagulation effects begin immediately upon infusion
Rapid elimination (half-life 39 to 51 minutes)
Predictable dose-dependent anticoagulation response
Major bleeding and adverse events were uncommon when compared to historical controls
Does not require dose adjustment based on renal impairment
Does not interact with heparin-dependent antibodies
No antigenicity on repeat administration
In a clinical trial, increased INR during warfarin conversion was not associated with an increase in major bleeding[12]

Important Safety Information

As with all anticoagulants, bleeding is a serious concern. Argatroban is contraindicated in patients with overt major bleeding or those with hypersensitivity to the product or any of its components. Argatroban should be used with extreme caution in disease states or other circumstances in which there is an increased risk of hemorrhage. Overall major bleeding was reported in 5.3% of Argatroban-treated patients with HIT versus 6.7% of the historical controls. Overall major bleeding was reported in 1.8% of Argatroban-treated patients undergoing PCI versus 3.1% of the historical controls. Intracranial bleeding was not observed in the 568 patients treated with Argatroban for HIT (with or without thrombosis) or in the 91 patients who underwent PCI. The most common nonhemorrhagic side effects in HIT patients, regardless of the relationship to treatment, were dyspnea, hypotension, and fever. In patients undergoing PCI, the nonhemorrhagic side effects, regardless of the relationship to treatment, included chest pain, hypotension, and back pain. Please see full Prescribing Information for additional safety information on Argatroban.