Can argatroban affect INR?
EFFECT ON INR Argatroban increases the INR. It is common to have INRs of 4 or 8 in patients on higher argatroban doses. This INR does not indicate a higher risk of bleeding, as it would in the patient receiving warfarin.
Is argatroban falsely elevated INR?
Argatroban is a direct thrombin inhibitor (DTI) that is known to cause a false elevation of the INR via lab assay interference.
Does argatroban increase PTT?
Monitoring of argatroban anticogulation An infusion of 2 μg/kg/min argatroban is expected to increase aPTT 1.5-fold, whereas an infusion of 10 μg/kg/min can prolong a PTT up to 3-fold.
Does argatroban increase aPTT?
Argatroban increases APTT, PT/INR, thrombin time, ecarin clotting time, and ACT in a dose-dependent fashion.
Does argatroban affect fibrinogen?
Argatroban may falsely reduce measured fibrinogen levels in vitro, caused by the Clauss method. Though clinically not significant, argatroban should be stopped in such conditions, in order to decrease the chance of mismanagement.
Do direct thrombin inhibitors affect INR?
Background: Direct thrombin inhibitors are recommended in confirmed or suspected heparin-induced thrombocytopenia. False elevation of the international normalized ratio (INR) occurs with these agents making bridging to warfarin challenging.
When can I start Argatroban after heparin?
Heparin infusion Argatroban/ Bivalirudin/ Enoxaparin/ Dalteparin/ Fondaparinux Initiate parenteral anticoagulant within 2 hours after discontinuation of heparin infusion.
When do you use argatroban?
Argatroban is a a small molecule, synthetic direct thrombin inhibitor. It is used as an alternative anticoagulant in patients with heparin-induced thrombocytopenia (HIT). It has a relatively short half life of 40-50 minutes and is eliminated by hepatic metabolism and biliary secretion.
How do you monitor argatroban?
Argatroban effect is typically monitored using activated partial thromboplastin time (APTT) measurements with a target of 1.5 to 3.0 times the patient’s baseline value.
Does Bival increase INR?
Bivalirudin’s effects on elevating the INR range from 0.37 to 0.55 over the course of therapy initiation and decreased the INR by 0.48 on bivalirudin discontinuation.