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Argatroban (Argatra^®) is a reversible, monovalent direct thrombin inhibitor available only as an infusion solution.

Argatroban is approved to continue anticoagulation in adults with type II heparin-induced thrombocytopenia (HIT).
The elimination of argatroban and its metabolites occurs mainly via the liver (65.4 ± 7.1%) less than the kidney (21.8 ± 5.8%). Thus, argatroban does not accumulate in cases of renal insufficiency. There is no antidote.

• Monitoring of anticoagulation using Argatra, while using a heart-lung machine or during percutaneous coronary intervention (PCI). With the doses of more than 1?g/ml argatroban, which are usual on the heart-lung machine or in PCI, the argatroban concentration/aPTT-time curve shows an asymptotic course, not a linear course.
• Measuring the coagulation inhibition in connection with argatroban can be useful in order to avoid excessive high exposure to argatroban if additional risk factors are present.

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3. Ströhle M, Niederwanger C, Irsara C, Fries D. A Prospective Pilot Trial to Assess the Efficacy of Argatroban (Argatra®) in Critically Ill Patients with Heparin Resistance. J Clin Med. 2020 Mar 31;9(4)
4. Dingman JS, Smith ZR, Coba VE, Peters MA, To L. Argatroban dosing requirements in extracorporeal life support and other critically ill populations. Thromb Res. 2020 May;189:69-76.
5. Evaluation of intravenous direct thrombin inhibitor monitoring tests: Correlation with plasma concentrations and clinical outcomes in hospitalized patients. Beyer JT, Lind SE, Fisher S, Trujillo TC, Wempe MF, Kiser TH. J Thromb Thrombolysis. 2020 Feb;49(2):259-267