Bivalirudin
Also known as: Angiomax, Hirulog
Bivalirudin (also called Angiomax or Hirulog) is an FDA-approved direct thrombin inhibitor. Bivalirudin is a synthetic twenty-amino-acid peptide modelled on hirudin, the anticoagulant of the medicinal leech. It is bivalent: one end occupies the catalytic site of thrombin while the other binds exosite 1, the fibrinogen recognition site, so it blocks both the enzymatic activity and the substrate docking that thrombin needs.
For research use only.
Key Facts
- CAS
- 128270-60-0
- Molecular Weight (MW)
- 2180.3 g/mol
- Half-life
- ~25 minutes (normal renal function)
- FDA status
- Approved
- Administration Route
- Intravenous
- Frequency
- Continuous IV infusion during procedure
- Last updated
- Aug 30, 2026
- Reviewed
- Aug 30, 2026
- Targets
- Thrombin (factor IIa)
Research summary
FDA-approved bivalent direct thrombin inhibitor used with PCI. IV bolus plus infusion per labeled weight-based regimen; hospital use only.
Peptide Library's Bivalirudin profile summarises 5 cited studies listed in the Science section, the compound's regulatory status, and research-protocol parameters reported for it. It is a research reference, not medical advice.
Protocol
- Dosage Range
- 0.75 mg/kg bolus followed by 1.75 mg/kg/hour infusion
- Frequency
- Continuous IV infusion during procedure
- Cycle
- Per procedure
- Administration Route
- Intravenous
- Reconstitution Guide
- Reconstitute with sterile water for injection per package insert
- Concentration Example
- 250 mg vial reconstituted to 5 mg/mL
- Timing Notes
- Administered intravenously during percutaneous coronary intervention
- Expected Onset
- Immediate anticoagulation effect
Not yet checked against primary sources
These figures are compiled from earlier reference material. They have not been verified against FDA labelling, registered trials or published literature, no citation is attached to them, and none of them is a recommended dose. Bivalirudin is queued for dosage evidence review.
Compare reported doses across the whole librarySequence & molecular data
| Molecular formula | C98H138N24O33 |
|---|---|
| Molecular weight | 2180.3 g/mol |
| CAS number | 128270-60-0 |
| Half-life | ~25 minutes (normal renal function) |
| Appearance | Lyophilized powder for IV solution |
| Formulation | Lyophilized Powder |
| PubChem CID | 16129704 |
| FDA UNII | TN9BEX005G |
| DrugBank | DB00006 |
Identifiers link to the public PubChem, FDA Substance Registration (UNII), ChEMBL and DrugBank records for the same entity.
Science
Mechanism of Action
Bivalirudin is a synthetic twenty-amino-acid peptide modelled on hirudin, the anticoagulant of the medicinal leech. It is bivalent: one end occupies the catalytic site of thrombin while the other binds exosite 1, the fibrinogen recognition site, so it blocks both the enzymatic activity and the substrate docking that thrombin needs. Unlike heparin it does not require antithrombin as a cofactor and it inhibits clot-bound as well as circulating thrombin. Its action is self-limiting: thrombin slowly cleaves the bound peptide, restoring activity, which gives a short and predictable offset without a reversal agent and makes it useful where heparin-induced thrombocytopenia is a concern.
Origin
Synthetic 20-amino-acid hirudin analog.
Targets
Studies
- Prospective Randomized Pilot Study Comparing Bivalirudin Versus Heparin in Neonatal and Pediatric Extracorporeal Membrane Oxygenation
- Bivalirudin in Extracorporeal Membrane Oxygenation
- Is it time to switch to bivalirudin for ECMO anticoagulation?
- Bivalirudin in pediatric extracorporeal membrane oxygenation
- Role of Bivalirudin for Anticoagulation in Adult Perioperative Cardiothoracic Practice
Regulatory & research status
Bivalirudin is an FDA-approved product for specific labelled indications. Approval does not extend to the research contexts described on this page, and approved products are prescription medicines.
| FDA status | Approved |
|---|---|
| Availability | Prescription-Only |
| WADA (sport) | Permitted |
| Library classification | FDA-Approved |
Benefits
Bivalirudin side effects
Side Effects
- Bleeding
- Back pain
- Nausea
- Hypotension
Storage & stability
Lyophilized (freeze-dried) peptide powder is far more stable than the reconstituted solution. Keep sealed vials cold, dry and away from light; long-term storage is typically frozen, with short-term refrigeration for vials in use.
Once reconstituted in bacteriostatic water, keep the solution refrigerated, avoid repeated freeze–thaw cycles and agitation, and label the vial with the reconstitution date and concentration. Discard any solution that turns cloudy or shows particulates.
Degradation rates differ by sequence: peptides containing methionine, cysteine, asparagine or glutamine are more prone to oxidation and deamidation, so shelf life after reconstitution is compound-specific rather than universal.
Read the full guide: how to store peptides before and after reconstitution →
Source: Manning MC, Chou DK, Murphy BM, Payne RW, Katayama DS. Stability of protein pharmaceuticals: an update. Pharm Res. 2010;27(4):544–575. (PMID 20143256). General guidance for research handling; not product-specific instructions.
Bivalirudin: frequently asked questions
What is Bivalirudin?
FDA-approved bivalent direct thrombin inhibitor used with PCI. IV bolus plus infusion per labeled weight-based regimen; hospital use only.
How does Bivalirudin work?
Bivalirudin is a synthetic twenty-amino-acid peptide modelled on hirudin, the anticoagulant of the medicinal leech. It is bivalent: one end occupies the catalytic site of thrombin while the other binds exosite 1, the fibrinogen recognition site, so it blocks both the enzymatic activity and the substrate docking that thrombin needs.
Is Bivalirudin FDA approved?
Yes. Bivalirudin is approved by the FDA, and approved products are prescription medicines. Approval is always for specific indications studied in clinical trials, so an approved status does not mean the compound is approved for every use it is discussed for. Research-chemical material sold under the same name is not the approved product.
What is the half-life of Bivalirudin?
Reported half-life for Bivalirudin is ~25 minutes (normal renal function). Half-life describes how long the compound persists in circulation, not how long any effect lasts, and published figures vary with route of administration, formulation and the population studied.
Is Bivalirudin banned in sport?
Bivalirudin is recorded here as permitted in sport. Anti-doping status is revised annually, so athletes subject to testing should confirm against the current WADA Prohibited List before use.
What peptides are similar to Bivalirudin?
Compounds most often compared with Bivalirudin include Abaloparatide and Teriparatide. They are grouped by shared mechanism or research area rather than by equivalence, and their regulatory status and evidence base differ.
References
- FDA label — AngiomaxExternal reference
- Prospective Randomized Pilot Study Comparing Bivalirudin Versus Heparin in Neonatal and Pediatric Extracorporeal Membrane Oxygenation — Pediatr Crit Care Med, 2025External reference
- Bivalirudin in Extracorporeal Membrane Oxygenation — J Cardiovasc Pharmacol, 2024External reference
- Is it time to switch to bivalirudin for ECMO anticoagulation? — Front Med (Lausanne), 2023External reference
- Bivalirudin in pediatric extracorporeal membrane oxygenation — Curr Opin Pediatr, 2022External reference
- Role of Bivalirudin for Anticoagulation in Adult Perioperative Cardiothoracic Practice — J Cardiothorac Vasc Anesth, 2020External reference
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Compiled by Peptide Library Editorial · Reviewed Aug 30, 2026 · Updated Aug 30, 2026 · Version 1
This Bivalirudin profile is compiled from published literature (5 cited studies linked above), public regulatory records and chemical registries. It describes what research reports; it is not medical advice, and nothing here is a dosing recommendation for humans. Peptide Library does not sell peptides. Editorial policy · How profiles are compiled · Report an error
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