Who can administer
  
                  Administration RESTRICTED - see Appendix 1
      
  
        Important information
  
                  
- May be used only in Cardiothoracic surgery on Consultant advice
 
- Unlicensed preparation in Ireland
 
- IMPORTANT: The ACT is NOT the same as the APTT. Results are not interchangeable.
 
      
  
        Available preparations
  
                  Bivalirudin 250mg vial
      
  
        Reconstitution
  
                  Water for injection
- Add 5mL per 250mg vial
 
- Swirl gently until fully dissolved and the solution is clear
 
- Reconstitution may take 3 to 4 minutes to be complete
 
- Dilute further prior to administration
 
- Take 5mL (250mg) of reconstitution solution and add to 45mL infusion fluid to produce a 5mg per mL solution- this diluted solution is used for both the bolus dose and the infusion (ref 1)
 
      
  
        Infusion fluids
  
                  Glucose 5% or Sodium Chloride 0.9%
      
  
        Methods of intravenous administration
  
                  Bolus intravenous injection (Cardiac surgery)
- Administer required dose as a rapid IV push
 
Continuous intravenous infusion (Cardiac surgery)
- Using a 5mg per ml solution (250mg in 50mL) - set up the continuous infusion
 
- Adjust dose as per Q pulse document
 
      
  
        Dose in adults
  
                  GUH: Only used in Cardiothoracic surgery
      
  
        Monitoring
  
                  
      
  
        Storage
  
                  
      
  
        References
  
                  1 Injectable Medicines guide, Medusa- downloaded Feb 7th, 2024
 
SPC (US product)
      
  
        Therapeutic classification
  
                  Anticoagulant