TheraRadar
Data updated: May 26, 2026

BIVALIRUDIN

Thrombin Inhibitors Genetically Validated
Cardiovascular Approved 2015-07-14

Bivalirudin is an anticoagulant used for patients undergoing percutaneous coronary intervention (PCI). It helps patients manage the risk of blood clots during these procedures, including those who have heparin-induced thrombocytopenia (HIT) or heparin-induced thrombocytopenia and thrombosis syndrome (HITTS). This medication works by preventing the thrombotic process through direct inhibition of thrombin.

Source: FDA Label • SLATE RUN PHARMA • Anti-coagulant

How BIVALIRUDIN Works

The drug works by binding to both the catalytic site and the anion-binding exosite of thrombin, which prevents the enzyme from activating platelets and converting fibrinogen into fibrin. This inhibits the formation of a cross-linked framework that stabilizes blood clots. Because thrombin slowly cleaves the drug, the binding is reversible and allows for the eventual recovery of thrombin's active site functions.

10
Indications
--
Phase 3 Trials
10
Years on Market

Details

Status
Prescription
First Approved
2015-07-14
Routes
INTRAVENOUS, INJECTION
Dosage Forms
INJECTABLE

BIVALIRUDIN Approval History

2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
Original
New Indication
New Form
Label Update
27 FDA actions from 2015 to 2025
Feb 2025 SUPPL
Label · Labeling
Nov 2023 SUPPL
Label · Labeling
May 2021 ORIGINAL
Update

What BIVALIRUDIN Treats

2 indications

BIVALIRUDIN is approved for 2 conditions since its original approval in 2015. These indications span multiple therapeutic areas including oncology, immunology, and more.

  • Heparin-Induced Thrombocytopenia
  • Heparin-Induced Thrombocytopenia and Thrombosis Syndrome
Source: FDA Label

BIVALIRUDIN Target & Pathway

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Target

THROMBIN (Coagulation Factor IIa) Coagulation Factor

The central enzyme in blood coagulation that converts fibrinogen to fibrin, forming blood clots. Direct thrombin inhibitors prevent clot formation and are used to prevent stroke and treat blood clots.

BIVALIRUDIN Competitive Set

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Three rings of competition based on shared molecular targets and treated indications.

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Filters applied: drops same-active-ingredient (505(b)(2) reformulations), route-mismatch (topical vs systemic), and cross-therapeutic-area matches in same-indication rings.

Drugs Similar to BIVALIRUDIN

FDA-approved drugs for similar conditions. Compare mechanisms and indications to understand treatment alternatives.

ANGIOMAX
BIVALIRUDIN
2 shared
Novartis
Shared indications:
Heparin-Induced ThrombocytopeniaHeparin-Induced Thrombocytopenia and Thrombosis Syndrome
ANGIOMAX RTU
BIVALIRUDIN
2 shared
MAIA PHARMS INC
Shared indications:
Heparin-Induced ThrombocytopeniaHeparin-Induced Thrombocytopenia and Thrombosis Syndrome
ARGATROBAN
ARGATROBAN
1 shared
Baxter
Shared indications:
Heparin-Induced Thrombocytopenia
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Clinical Trial Registry

21 trials
Trial Sponsor ID Phase Status Title
NCT05959252 BLUSH 2023/ETH00443 Ph 2 recruiting BivaLirudin versUS Heparin in Extracorporeal Membrane Oxygenation
NCT06080074 TROLLEY 72467 Ph 2 recruiting Multicenter Trial of ECMO in Children With Severe Cardiac Failure Using the Cardiohelp System
NCT05984537 PCI ZHENG Bo. Ph 4 recruiting A Study on the Impact of Bivalirudin Usage During PCI for High-risk Plaques on Post-PCI Coronary Microcirculation.
NCT03664180 RIGHT 2018024X BJUHFRIGHT201802 Ph 4 completed Comparison of Anticoagulation Prolongation vs. no Anticoagulation in STEMI Patients After Primary PCI
NCT03318393 results posted 072017-045 Ph 4 completed Study Comparing Bivalirudin Versus Heparin in Neonatal and Pediatric ECMO
NCT03588611 RE-20180628 Ph 4 completed Reduce Bolus Injection of Bivalirudin
NCT00759083 TMC-BIV-07-02 Ph 4 withdrawn Bivalirudin PCI Registry in Heparin Induced Thrombocytopenia/Heparin Induced Thrombocytopenia and Thrombosis Syndrome (HIT/HITTS) Patients
NCT02565147 BIVAL results posted MDCO-BIV-12-02 2012-002314-39 Ph 3 terminated Bivalirudin Infusion for Ventricular Infarction Limitation
NCT02448550 CALIFORNIA KP-RRC-CE1 Ph 3 terminated Comparison of Anticoagulation for All-comers Undergoing Percutaneous Coronary Revascularization Trial
NCT01913483 ENDOMAX results posted MDCO-BIV-12-03 Ph 3 terminated ENDOvascular Interventions With AngioMAX: The ENDOMAX Trial
NCT02311231 VALIDATE EudraCT nr: 2012-005260-10 Ph 4 completed Bivalirudin vs Heparin in NSTEMI and STEMI in Patients on Modern Antiplatelet Therapy in SWEDEHEART
NCT01651780 BRAVO 2/3 results posted TMC-BIV-11-02 2012-000632-26 Ph 3 completed Open-label, Randomized Trial in Participants Undergoing TAVR to Determine Safety & Efficacy of Bivalirudin vs UFH
NCT00812370 UNBLOCK 3070850 Ph 1 completed The UNBLOCK Study: Utilization of Bivalirudin On Clots in Kids
NCT01848899 results posted 12-02409 Ph 4 completed Effects Contrast on Platelet Activity, Thrombosis and Fibrinolysis in Patients Undergoing Coronary Angiography
NCT01087723 EUROMAX results posted TMC-BIV-08-03 Ph 3 completed European Ambulance Acute Coronary Syndrome (ACS) Angiography Trial
NCT00616460 ACRIPAB 0124-07-EMC Ph 3 completed ACRIPAB- Trial: Anti Coagulation Regimen In High Risk PAtients for Bleeding
NCT01519518 HEAT-PPCI results posted 923 Ph 4 completed How Effective Are Antithrombotic Therapies in Primary Percutaneous Coronary Intervention
NCT01464671 STATUS PCI 119778 (IRB ID) Ph 4 terminated Angiomax® or Unfractionated Heparin for Patients Undergoing Percutaneous Coronary Intervention
NCT01848106 Regulate REG1-CLIN310 2013-001384-23 Ph 3 terminated A Study To Determine the Efficacy and Safety of REG1 Compared to Bivalirudin in Patients Undergoing PCI
NCT01696110 BRIGHT SYNH20120001 2011BAI11B07 Ph 4 completed BivaliRudin in Acute Myocardial Infarction vs Glycoprotein IIb/IIIa and Heparin :a Randomised Controlled Trial.
NCT01465503 NAPLESIII NCTCM02 Ph 3 completed Novel Approaches in Preventing and Limiting Events III Trial (NAPLES III): Bivalirudin in High-risk Bleeding Patients
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Active Pipeline

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Ongoing clinical trials by development phase

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Key Completed Trials

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Completed studies with published results, ranked by significance

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Trial Timeline

Full development history with FDA approval milestones

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Understanding FDA Approval Types
Count Type What it means
- ORIG Original approval - drug first enters market
- SUPPL - Efficacy New indication (new disease/condition approved)
- SUPPL - Labeling Label text changes (warnings, dosing updates)
- SUPPL - Manufacturing Production changes (new facility)
- SUPPL - Chemistry Formulation changes (new dosage strength)

Green lines in the timeline show ORIG and Efficacy approvals - the clinically meaningful milestones.

BIVALIRUDIN FDA Label Details

Indications & Usage

FDA Label (PDF)

BIVALIRUDIN is indicated for the treatment of Heparin-Induced Thrombocytopenia; Heparin-Induced Thrombocytopenia and Thrombosis Syndrome.

Looking for the branded version?

ANGIOMAX

Full clinical data, patents, trials, and competitive landscape for bivalirudin.

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Data Sources

Data sourced from official FDA and NIH databases. Click links to verify on original sources.