Consumer Information for: ANGIOMAX

Angiomax is only administered by trained medical professionals through an intravenous line.

Angiomax will be administered to you after it has been dissolved in sterile water and diluted to a final concentration of 5 mg/mL.

As with all intravenous (IV) mixtures, Angiomax should be inspected visually for clarity, solid particles, discolouration and leakage prior to administration whenever solution and container permit. Solutions showing haziness, solid particles, discolouration or leakage should not be used. Discard unused portion.

Usual Dose

The dose of Angiomax you will receive will be based on your weight and will depend on what procedure, PCI or cardiac surgery, you are going to have.

ACS
Angiomax should be given as an IV bolus dose of 0.1 mg/kg followed by an infusion of 0.25 mg/kg/hr through the angiography procedure for as long as needed.

If you are going to undergo the PCI procedure, you will receive an additional IV bolus dose of 0.5 mg/kg at the start of the procedure, and this will be increased to 1.75 mg/kg/hr for the entire procedure. After the procedure, your doctor may decide to give you a reduced infusion dose for as long as needed.

If you are going to undergo off-pump cardiac surgery, you will receive an additional IV bolus dose of 0.5 mg/kg just before surgery followed by a 1.75 mg/kg/h dose during the entire procedure.

If you are going to undergo on-pump cardiac surgery, the initial infusion will be continued until 1 hour before the procedure at which point you will be treated with unfractionated heparin.

PCI
Angiomax should be given as an IV bolus dose of 0.75 mg/kg followed by an infusion of 1.75 mg/kg/hr for the entire procedure. Your doctor may decide to continue it for 4 hours after your procedure, and you may be continued on an infusion at a reduced dose of 0.25 mg/kg/hr for 4-12 hours, as needed. Angiomax is intended for use with acetylsalicylic acid (ASA) and may be used with clopidogrel. If you have severe kidney disease, the infusion dose may have to be reduced to 1.0 mg/kg/hr. If you are on dialysis, the infusion rate should be reduced to 0.25 mg/kg/hr.

Cardiac Surgery
On-pump Cardiac Surgery: Angiomax should be given as an IV bolus dose of 1.0 mg/kg followed by an infusion of 2.5 mg/kg/hr. Angiomax infusion may be terminated approximately 15 minutes prior to the anticipated end of cardiopulmonary bypass (CPB). If CPB is not terminated within 20 minutes or if you need to go back on bypass, a bivalirudin IV bolus of 0.5 mg/kg should be administered and a 2.5 mg/kg/hr i.v. infusion restarted and continued until 15 minutes prior to the anticipated end of CPB.

Off-pump Cardiac Surgery: Angiomax should be given as an IV bolus dose of 0.75 mg/kg followed by an infusion of 1.75 mg/kg/hr for the duration of the procedure.

Patients with severe kidney disease have not been studied in cardiac surgery using Angiomax.

Angiomax can be started 30 minutes after discontinuation of unfractionated heparin and 8 hours after discontinuation of low molecular weight heparin.

Angiomax can be used with a glycoprotein IIb/IIIa (GPIIb/IIIa) inhibitor (drug that prevents platelets from binding together).

Overdose

Overdosage with single bolus doses of Angiomax up to 7.5 mg/kg may result in increased bleeding or adverse events. If overdose occurs, Angiomax should be discontinued and the patient should be monitored closely for signs of bleeding. Supportive therapy to treat any symptoms should be started as needed. Once the administration of Angiomax has been stopped, there is a gradual reduction in the risk for bleeding as the body breaks down the drug. There is no known antidote to Angiomax. Angiomax is removed from the blood by dialysis.