Argatroban use in heparin-induced thrombocytopenia

Expert Opin Pharmacother. 2008 Aug;9(11):1963-7. doi: 10.1517/14656566.9.11.1963.

Abstract

Background: Heparin-induced thrombocytopenia (HIT) is a serious, life-threatening complication which occurs in 1-3% of patients receiving heparin. Patients with untreated HIT have an up to 50% risk of developing life- and limb-threatening thromboembolic complications. Treatment is based upon clinical suspicion, stopping heparin therapy and initiation of anticoagulation with a rapidly acting alternative non-heparin anticoagulant, such as argatroban-a hepatically excreted direct thrombin inhibitor which is effective in the treatment of HIT.

Objective: To summarize the pharmacological and clinical data, and discuss the impact of argatroban in the current treatment of HIT.

Methods: A literature search was performed with the aid of Pubmed and Google. Search parameters of 'argatroban', 'heparin-induced thrombocytopenia' and 'treatment' were input into both search engines.

Conclusion: Argatroban is a safe and effective treatment for HIT. In patients taking other hepatically cleared medications, lower initial doses may have to be used to avoid over-anticoagulation.

Publication types

  • Review

MeSH terms

  • Anticoagulants / adverse effects
  • Anticoagulants / pharmacokinetics
  • Anticoagulants / therapeutic use*
  • Arginine / analogs & derivatives
  • Clinical Trials as Topic
  • Heparin / adverse effects*
  • Humans
  • Liver / metabolism
  • Pipecolic Acids / adverse effects
  • Pipecolic Acids / pharmacokinetics
  • Pipecolic Acids / therapeutic use*
  • Sulfonamides
  • Thrombocytopenia / chemically induced*
  • Thrombocytopenia / complications
  • Thrombocytopenia / drug therapy
  • Thromboembolism / etiology
  • Thromboembolism / prevention & control

Substances

  • Anticoagulants
  • Pipecolic Acids
  • Sulfonamides
  • Heparin
  • Arginine
  • argatroban