What does argatroban do to INR?

What does argatroban do to INR?

Argatroban prolongs the INR more than lepirudin or bivalirudin, and a higher-than-usual target INR during warfarin co-therapy (which depends on the thromboplastin reagent used to measure the INR) can be expected (see Caveats in Treatment of Heparin-Induced Thrombocytopenia).

Does argatroban raise INR?

Elevated INRs during concurrent warfarin/argatroban therapy should not be interpreted as therapeutic if they are between 2.0 –3.0, or as supratherapeutic if they are > 3.0. A valid INR can only be obtained by holding argatroban for approximately 4 hours prior to checking INR.

When can I start taking warfarin after argatroban?

If there is hepatic insufficiency, start parenteral anticoagulant after 2-4 hours of stopping argatroban.

Is argatroban reversible?

Argatroban is a reversible DIT. It is a synthetic peptide derived from arginine. Argatroban is licensed by the Food and Drug Administration for the treatment of HIT in children in the United States. Patients are treated with a continuous infusion.

What is the antidote for argatroban?

Argatroban has no specific antidote, and if excessive anticoagulation occurs, argatroban infusion should be stopped or reduced.

How do you reverse argatroban?

Argatroban has a short half-life of around 45 minutes – stopping the infusion and initiating general measures should achieve reversal. There is a licensed antidote, idarucizumab, for rapid reversal of dabigatran for emergency surgery and procedures or in life-threatening or uncontrolled bleeding.

How do you transition from argatroban to heparin?

Argatroban Enoxaparin/ Dalteparin/ Fondaparinux/ Heparin If no hepatic insufficiency, start parenteral anticoagulant within 2 hours of discontinuing argatroban infusion. If there is hepatic insufficiency, start parenteral anticoagulant 2-4 hours after discontinuing argatroban infusion.

What type of blood thinner is argatroban?

It is a direct thrombin inhibitor, a class of anticoagulant drugs. This activity outlines the indications, action, and contraindications for argatroban as a valuable agent in the prophylaxis and treating thrombosis in patients with HIT.

What is used for reversal of warfarin?

PCC will reverse anticoagulation within minutes of administration; FFP administration can take hours due to the volume required; vitamin K effect takes 12 to 24 hours, but administration of vitamin K is needed to counteract the long half-life of warfarin.

Is there an antidote for argatroban?

No specific antidote to Argatroban is available; if life-threatening bleeding occurs and excessive plasma levels of Argatroban are suspected, discontinue Argatroban immediately and measure aPTT and other coagulation parameters.

How is excessive anticoagulation treated in patients on argatroban?

Excessive anticoagulation, with or without bleeding, may be controlled by discontinuing Argatroban or by decreasing the Argatroban dose. In clinical studies, anticoagulation parameters generally returned from therapeutic levels to baseline within 2 to 4 hours after discontinuation of the drug.

Can argatroban be converted to warfarin?

Conversion to warfarin raises some difficulty since argatroban raises the PT (and therefore INR) in addition to the aPTT. Therefore, in order to assess if a therapeutic INR (pertaining to warfarin) has been reached, the argatroban infusion needs to be temporarily held and labs drawn.

Can argatroban be used to treat heart failure?

There is evidence that a reduced initial dose may also be advisable for patients with heart failure, multiple organ dysfunction, severe anasarca, or after cardiac surgery. Given this information, argatroban can be effectively used in treating HIT with monitoring of activated partial thromboplastin time.