Bivalirudin is a direct thrombin inhibitor that treats heparin-induced thrombocytopenia and prevents thrombosis. It binds reversibly to the active site of thrombin inhibiting its activation of fibrinogen and coagulation factor XIII. Without the conversion of fibrinogen into fibrin the formation of a thrombus is stopped. Inactivation of coagulation factor XIII further inhibits blood clot formation, as this factor is responsible for stabilizing cross-linking fibrin creating the meshwork for the clot. This drug is commonly administered intravenously and is metabolized by proteolytic cleavage. Bivalirudin is cleared from plasma by the renal system and proteolytic cleavage. This drug interacts with food, echinacea needs to be avoided in addition to herbs and supplements that have anticoagulant and antiplatelet activity. These herbs and supplements include ginger, garlic, bilberry, danshen, piracetam and ginkgo biloba.

Bivalirudin Pathway References