Weight-Based Argatroban Dosing Nomogram for Treatment of Heparin-Induced Thrombocytopenia

Abstract

The nomogram is an effective dosing tool for achieving and maintaining therapeutic levels of anticoagulation.

Treatment options in heparin-induced thrombocytopenia

“…Despite being given lower doses of argatroban (mean 0.82 vs. 1.25 mg/kg/min), these patients had more major bleeding episodes (4 vs. 0, P ¼ 0.04) as compared to non-ICU patients [64 ]. This study suggests that critical illness alone is sufficient to warrant dose reductions, and a weight-based nomogram has been proposed, but has not been fully evaluated [65 ].…”

Les inhibiteurs directs de la thrombine, l’hirudine, la bivalirudine, l’argatroban, et le dabigatran etexilate

“…Il est aussi indiqué au cours d'une intervention coronarienne percutanée (PCI) chez les patients atteints d'une thrombopénie induite par l'héparine [42]. Un nomogramme pour la posologie de l'argatroban dans le traitement des TIH a été proposé en 2009 [43].…”

Pharmacology of argatroban

“…Upon cessation of infusion, plasma drug levels decay with a half-life of 39-51 min. A nomogram has been developed to help rapidly achieve and maintain doses in the therapeutic range and to guide dosing adjustments when required [16]. The nomogram assumes an initial dose of 2 µg/kg/min.…”

“…In hepatically impaired HIT patients, significantly lower doses of argatroban were used to achieve the desired aPTT prolongation [23]. A nomogram has been developed to aid dosing in hepatically impaired and critically ill patients [16]. The initial argatroban dose in these patients is 0.5 µg/kg/min.…”