Bivalirudin, Injection

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KEY POINTS

• This medicine is given by IV to prevent blood clots.
• This medicine increases your risk of bleeding. Be careful while shaving, cutting fingernails or toenails, or when using sharp objects.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: anticoagulant (medicine that reduces the chance of blood clots forming); thrombin inhibitor

Generic and brand names: bivalirudin, injection; Angiomax

What is this medicine used for?

This medicine is given by IV infusion (slow drip through a needle into a large vein) to prevent blood clots from forming in people with unstable angina (chest pain) or other conditions during procedures used to unblock a blood vessel. It is usually used with aspirin.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• Bleeding problems
• High blood pressure
• A stroke or transient ischemic attack (TIA)
• Kidney problems
• Ulcers

Tell your healthcare provider if you have recently had surgery or major bleeding problems.

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

This medicine will be given by your healthcare provider in a hospital or clinic. You will receive a shot in your IV tubing, then an IV infusion (slow drip). Your healthcare provider will determine how long you will receive this medicine based on your condition. Talk with your healthcare provider about this.

What should I watch out for?

There is a risk of bleeding at the spot where you have your IV. Watch carefully for any signs of bleeding or bruising and report them to your healthcare provider right away.

Use a soft brush to brush your teeth. Be careful while shaving, cutting fingernails or toenails, or when using sharp objects. Avoid sports and activities that may cause injuries. If you fall or are injured, contact your healthcare provider right away.

Adults over the age of 65 may be at greater risk for side effects. Talk with your healthcare provider about this.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you have received this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; chest pain or tightness in your chest; swelling of your lips, tongue, and throat); sudden weakness, numbness, or tingling, especially on one side of your body; sudden or severe headache; sudden trouble with vision, speech, balance, or walking.

Serious (Report these to your healthcare provider right away.): Heavy bleeding or pain at the IV site, nose bleeds, vomiting blood or material that looks like coffee grounds, bleeding gums, black or tarry bowel movement, blood in urine, unusual bruising or bleeding, chest pain, severe dizziness, fainting, slow heartbeat, fever, trouble urinating, decreased urinating.

Other: Back pain; headache; lightheadedness; stomach pain; trouble sleeping; nervousness; nausea; vomiting; pain, redness, or swelling at injection site.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Aspirin and other salicylates
• Medicines to treat or prevent blood clots such as anagrelide (Agrylin), apixaban (Eliquis), argatroban, bivalirudin (Angiomax), cilostazol (Pletal), clopidogrel (Plavix), dabigatran (Pradaxa), dipyridamole (Persantine), enoxaparin (Lovenox), eptifibatide (Integrilin), fondaparinux (Arixtra), lepirudin (Refludan), prasugrel (Effient), rivaroxaban (Xarelto), ticagrelor (Brilinta), tirofiban (Aggrastat), and warfarin (Coumadin)
• Medicines to treat pulmonary hypertension such as epoprostenol (Flolan, Veletri), iloprost (Ventavis), and treprostinil (Remodulin, Tyvaso)
• Natural remedies such as alfalfa, angelica, anise, arnica, bilberry, bladderwrack, bromelain, capsicum, cat's claw, chamomile, dong quai, evening primrose, fenugreek, feverfew, fish oil, garlic, ginger, ginkgo, ginseng, glucosamine, grape seed, green tea, horse chestnut, licorice, papain, passionflower, red clover, reishi, SAMe, sweet clover, tumeric, and willow
• Nonsteroidal anti-inflammatory medicines (NSAIDs) such as celecoxib (Celebrex), diclofenac (Cambia, Voltaren, Zipsor), ibuprofen (Advil, Motrin), indomethacin (Indocin), ketoprofen, ketorolac, nabumetone (Relafen), naproxen (Aleve, Anaprox, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)
• Paroxetine (Brisdelle, Paxil, Pexeva)
• SSRI antidepressants such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), and sertraline (Zoloft)
• Vitamin E or multivitamins that contain vitamin E

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Keep all medicines out of the reach of children.

Do not share medicines with other people.