bivalirudin (Angiox)

Following a full submission

bivalirudin (Angiox) is accepted for restricted use within NHS Scotland for the treatment of adult patients with acute coronary syndromes (unstable angina/non-ST segment elevation myocardial infarction) planned for urgent or early intervention. It is restricted to use in patients who would otherwise have been considered for heparin in combination with a glycoprotein IIb/IIIa antagonist. In these patients bivalirudin monotherapy may be a suitable alternative. It should not be used as an alternative to heparin alone.

Bivalirudin should be administered with aspirin and clopidogrel.

Bivalirudin showed a reduced risk of bleeding compared to a heparin-based anticoagulant strategy in patients with moderate and high risk acute coronary syndromes undergoing early invasive management.