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argatroban

argatroban
  • Restricted Medications IV infusion
Drug Name Form Strength Non-Formulary Restricted TX Sub Notes
argatroban SOLUTION, INTRAVENOUS 1 mg/mL      
Display Direct Thrombin Inhibitors Class: 20120412
High Alert Drug : Policy
Medication comments:

prothrombin complex (Kcentra) is not an appropriate antidote for argatroban in HIT patients!
argatroban should generally not be interrupted during procedures unless there is a specific physician order.
Dosage Adjustment Nomogram
Goal aPTT = 40 – 81 seconds or 1.5 – 3 times baseline. NOT TO EXCEED aPTT of 100 seconds or 10 mcg/kg/min.
aPTT(secs) Adjustment Next aPTT
< 40 Increase rate by 20%
(Multiply current rate by 1.2 = new rate)
DO NOT EXCEED 10 mcg/kg/min		 2 hours
40-81 No Change 2 hours. If aPTT is in goal range for 2
consecutive readings, recheck in a.m.
82-100 Hold for 30 minutes, then increase rate by 50%
(Multiply previous rate by 0.5 = new rate)		 2 hours.
>100 Stop infusion. Recheck aPTT every 2 hours until < 80.
When <80, resume drip at 50% previous rate.
(Multiply previous rate by 0.5 = new rate)		 2 hours after restarting infusion.
*Rate change orders must specify revised dose in mcg/kg/min and mL/hr and must be calculated by the ordering physician.
High Alert Drug: direct thrombin inhibitors
 • Nurses and pharmacists verify dose and that patient is not on heparin or other anticoagulant prior to administration.
 • Two RNs independently verify dose prior to administration if the dosing requires manipulation (i.e. drawing up a portion of a vial, or giving a portion of a syringe}.
 • Anticoagulation comparison chart available on nursing units for reference.
 • Pharmacists/nurses provide patient education for oral anticoagulants.
 • Pharmacists monitor labs for appropriate dosing and prevention of adverse events.
 • Reversal agents and order sets for oral anticoagulants
Per policy, these medications require cardiac and/or special monitoring.
(KEY: "Y" = may be given as described on chart. "N" = may NOT be given except in Rapid Response/Code Blue situations or as otherwise described in Exceptions section of Policy.
generic (Brand) / Notes CCU, OR, PACU, CCL, ED PCU 2N (Tele) 1N (Tele), 3N (Tele) Med/Surg (1N w/o Tele, 3N w/o Tele, 4N, 5N) BirthPlace SNF ICS OPS
argatroban
IV Infusion		 Y Y Y Y Y Y N N N
Per policy, these hazardous drugs have special waste requirements. 
Generic (Brand) Waste Requirements
argatroban Hazardous Waste ⇒  BLACK BUCKET 
Anticoagulant / Antiplatelet Stoppage For Procedures
generic (Brand) Dept. Procedure Type
(hover over entry for examples)		 Stop Medication Prior To Procedure Restart after:
argatroban Anesthesia High-risk No data Restart after No data
Intermediate-risk No data Restart after No data
Low-risk No data Restart after No data
Patients with high risk of bleeding (eg, old age, history of bleeding tendency, concurrent uses of other anticoagulants/antiplatelets, liver cirrhosis or advanced liver disease, and advanced renal disease) undergoing low- or intermediate-risk procedures should be treated as intermediate or high risk, respectively.
Radiology
 Invasive Procedures 8 hours
Paracentesis/Thoracentesis No hold
Surgery High-risk No data Restart after No data
Low-risk No data Restart after No data
Last updated: Jul. 8, 2026
  • Hazardous Waste BLACK BUCKET
  • Look-Alike/Sound-Alike argatroban confused with Aggrastat, Orgaran
UpToDate Lexidrug

Pharmacy Contact Info:

Main Inpatient Pharmacy: ext 4599, 3503
Fax: 704-878-7283

Director of Pharmacy - Randi Raynor, PharmD: ext 4501
Clinical Coordinator - Laura Rollings, PharmD: ext 4597
Pharmacy Informaticist - Stephen Pringle, PharmD: ext 7645
Pharmacy Technician Supervisor - Amy Wingler, CPhT: ext 7385
Pharmacy Automation Coordinator (Omnicell) - Melissa Fulford, CPhT: ext 3556



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