Argatroban monohydrate

Indications & Dose:

Anticoagulation in patients with heparin-induced thrombocytopenia type II who require parenteral antithrombotic treatment % INITIALLY BY CONTINUOUS INTRAVENOUS INFUSION% Adult: Initially 2 micrograms/kg/minute, dose to be adjusted according to activated partial thromboplastin time, (by intravenous infusion) increased to up to 10 micrograms/kg/minute maximum duration of treatment 14 days Anticoagulation in patients with heparin-induced thrombocytopenia type II who require parenteralantithrombotic treatment (for dose in cardiac surgery, percutaneous coronary intervention, or critically ill patients) % BY CONTINUOUS INTRAVENOUS INFUSION% Adult: (consult product literature)Anticoagulation in patients with heparin-induced thrombocytopenia type II who require parenteral antithrombotic  treatment (when initiating concomitant warfarin treatment) % BY CONTINUOUS INTRAVENOUS INFUSION % Adult: Reduced to 2 micrograms/kg/minute, dose should be temporarily reduced and INR measured after 4–6 hours; warfarin should be initiated at intended maintenance dose (do not give loading dose of warfarin); consult product literature for further details

Contraindications:

Side Effects:

%Common or very common Haemorrhage . nausea . purpura %Uncommon Alopecia . constipation . deafness diarrhoea .dizziness . fever . gastritis . headache . hepatic failure . hepatomegaly . hiccups . hyperbilirubinaemia . hypertension . hypoglycaemia . hyponatraemia . hypotension . malaise . muscle weakness . myalgia . rash . renal impairment . sweating . syncope . tachycardia . visual disturbance . vomiting PREGNANCY Manufacturer advises avoid unless essential—limited information available. BREAST FEEDING Avoid—no information available. HEPATIC IMPAIRMENT Reduce initial dose to 500 nanograms/kg/minute in moderate impairment. Avoid in severe impairment or in patients with hepatic impairment undergoing percutaneous coronary intervention. MONITORING REQUIREMENTS Determine activated partial thromboplastin time 2 hours after start of treatment, then 2 or 4 hours after infusion rate altered (consult product literature), and at least once daily thereafter.DIRECTIONS FOR ADMINISTRATION For intravenous infusion (Exembol ®) give continuously in Glucose 5% or Sodium chloride 0.9%. Dilute each 2.5-mL vial with 250mL infusion fluid

Cautions:

Bleeding  disorders  diabetic retinopathy  immediately after gastro-intestinal ulceration lumbar puncture . major surgery (especially of brain, spinal cord, or eye) . risk of bleeding . severe hypertension . spinal anaesthesia

Precautions:

Interaction:

Appendix 1 (argatroban).Caution with concomitant use of drugs that increase risk of bleeding

Warnings:

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