All orders for anticoagulants (i.e. heparin subcutaneous, enoxaparin, warfarin) must be discontinued
The standard argatroban preparations are 50mg/50 mL IVPB or 250mg/250mL IVPB. Final product is to be determined by the pharmacy based on rate, expected duration, and available products.
Monitoring:
Baseline PTT should be drawn 3 hours after heparin has been stopped or 8 hours after the last dose of enoxaparin. Argatroban drip should be started 15-30 minutes after baseline PTT is drawn.
May decrease to daily PTT once two consecutive PTT levels are within the therapeutic range. If any daily PTT level is outside of the therapeutic goal, PTT levels must be resumed every 2 hours after adjusting the infusion rate until two therapeutic levels are obtained again.
Baseline CBC, then every other day, or more frequently if ordered by the provider
Notify Physician
If PTT exceeds 100 seconds
If Hemoglobin decreases by 2 g/dL
If signs of bleeding occur
Argatroban rate exceeds 10 mcg/kg/min
* Once two consecutive PTT levels are within range, may collect daily with AM labs
** Maximum rate is 10 mcg/kg/min. Notify provider if patient reaches this rate.
Reviewed by: UMC Pharmacy
Date: 10/1/2022
Version: 2
