Bivalirudin and Weed
Edited by Hugh Soames
Advertising: We may earn a commission if you buy anything via our advertising or external links
Bivalirudin and Weed
Most people who consume marijuana do so for its mood-altering and relaxing abilities. Weed gives people a high and allows them to relax. However, heavy consumption of weed can cause unwanted results. It can increase the anxiety and depression a person experiences, and it can interact with certain other drugs including Bivalirudin. It is important to remember that interactions do occur with all types of drugs, to a great or lesser extent and this article details the interactions of mixing Bivalirudin and Weed.
Mixing Bivalirudin and Weed
Bivalirudin (Bivalitroban), sold under the brand names Angiomax and Angiox and manufactured by The Medicines Company, is a direct thrombin inhibitor (DTI).
Chemically, it is a synthetic congener of the naturally occurring drug hirudin, found in the saliva of the medicinal leech Hirudo medicinalis.
Bivalirudin lacks many of the limitations seen with indirect thrombin inhibitors, such as heparin. A short, synthetic peptide, it is a potent and highly specific inhibitor of thrombin that inhibits both circulating and clot-bound thrombin, while also inhibiting thrombin-mediated platelet activation and aggregation. Bivalirudin has a quick onset of action and a short half-life. It does not bind to plasma proteins (other than thrombin) or to red blood cells. Therefore, it has a predictable antithrombotic response. There is no risk for heparin-induced thrombocytopenia or heparin-induced thrombosis-thrombocytopenia syndrome. It does not require a binding cofactor such as antithrombin and does not activate platelets. These characteristics make bivalirudin an ideal alternative to heparin.
Bivalirudin clinical studies demonstrated consistent positive outcomes in patients with stable angina, unstable angina (UA), non–ST-segment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI) undergoing PCI in seven major randomized trials. Patients receiving bivalirudin had fewer adverse events compared to patients that received heparin.
Bivalirudin is a 20 amino acid long peptide with the sequence D-Phe-Pro-Arg-Pro-Gly-Gly-Gly-Gly-Asn-Gly-Asp-Phe-Glu-Glu-Ile-Pro-Glu-Glu-Tyr-Leu (FPRPGGGGNGDFEEIPEEYL), where the first residue is D-phenylalanine instead of the natural L-phenylalanine.
Bivalirudin directly inhibits thrombin by specifically binding both to the catalytic site and to the anion-binding exosite of circulating and clot-bound thrombin. Thrombin is a serine proteinase that plays a central role in the thrombotic process. It cleaves fibrinogen into fibrin monomers, activates Factor V, VIII, and XIII, allowing fibrin to develop a covalently cross-linked framework that stabilizes the thrombus. Thrombin also promotes further thrombin generation, and activates platelets, stimulating aggregation and granule release. The binding of bivalirudin to thrombin is reversible as thrombin slowly cleaves the bivalirudin-Arg3-Pro4 bond, resulting in recovery of thrombin active site functions.
-Normal renal function (≥ 90 mL/min) = 25 minutes
-Mild renal dysfunction (60–89 mL/min) = 22 minutes
-Moderate renal dysfunction (30-59 mL/min) = 34 minutes
-Severe renal dysfunction (≤ 29 mL/min) = 57 minutes
-Dialysis-dependent = 3.5 hours
Pharmacodynamics
Coagulation times return to baseline approximately 1 hour following cessation of bivalirudin administration.
Bivalirudin is intended for IV use only and is supplied as a sterile, lyophilized product in single-use, glass vials. After reconstitution, each vial delivers 250 mg of bivalirudin.
US dosing:
EU dosing:
-Bolus: 0.1 mg/kg
-Infusion: 0.25 mg/kg/h for up to 72 hours for medical management
-If patient proceeds to PCI, an additional bolus of 0.5 mg/kg of bivalirudin should be administered before the procedure and the infusion increased to 1.75 mg/kg/h for the duration of the procedure.
-Bolus: 0.75 mg/kg
-Infusion: 1.75 mg/kg/h
-Patients proceeding to CABG surgery off-pump:
The IV infusion of bivalirudin should be continued until the time of surgery. Just prior to surgery, a 0.5 mg/kg bolus dose should be administered followed by a 1.75 mg/kg/h infusion for the duration of the surgery.
-Patients proceeding to CABG surgery on-pump:
The IV infusion of bivalirudin should be continued until 1 hour prior to surgery after which the infusion should be discontinued
Five minutes after the bolus dose has been administered, an activating clotting time (ACT) should be performed and an additional bolus of 0.3 mg/kg should be given if needed.
Continuation of the bivalirudin infusion following PCI for up to 4 hours post-procedure is optional, at the discretion of the treating physician. After 4 hours, an additional IV infusion of bivalirudin may be initiated at a rate of 0.2 or 0.25 mg/kg/h for up to 20 hours, if needed.
Bivalirudin should be administered with optimal antiplatelet therapy (aspirin plus clopidogrel).
Renal impairment
A reduction in the infusion dose of bivalirudin should be considered in patients with moderate or severe renal impairment. If a patient is on hemodialysis, the infusion should be reduced to 0.25 mg/kg/h. No reduction in the bolus dose is needed.
Bivalirudin is contraindicated in patients with active major bleeding and hypersensitivity to bivalirudin or its components. (In the EU bivalirudin is also contraindicated in patients with an increased risk of bleeding due to hemostasis disorders and/or irreversible coagulation disorders, severe uncontrolled hypertension, subacute bacterial endocarditis, and severe renal impairment [GFR<30 ml/min] and in dialysis-dependent patients).
Bivalirudin is an anticoagulant. Therefore, bleeding is an expected adverse event. In clinical trials, bivalirudin treated patients exhibited statistically significantly lower rates of bleeding than patients treated with heparin plus a GP IIb/IIIa inhibitor. The most common (≥10%) adverse events of bivalirudin are back pain, pain, nausea, headache, and hypotension.
Bivalirudin is classified as Pregnancy Category B.
The U.S. Food and Drug Administration (FDA) granted pediatric exclusivity for bivalirudin, based on studies submitted in response to a written request by the FDA to investigate the use of bivalirudin in pediatric patients aged birth to 16-years old.
The submission was based on a prospective, open-label, multi-center, single arm study evaluating bivalirudin as a procedural anticoagulant in the pediatric population undergoing intravascular procedures for congenital heart disease.
Study outcomes suggest that the pharmacokinetic (PK) and pharmacodynamic (PD) response of bivalirudin in the pediatric population is predictable and behaves in a manner similar to that in adults.
Bivalirudin is supported by 7 major randomized trials. These trials include REPLACE-2 (Randomized Evaluation of PCI Linking Angiomax to Reduced Clinical Events-2), BAT (Bivalirudin Angioplasty Trial), ACUITY (Acute Catheterization and Urgent Intervention Triage Strategy Trial), and HORIZONS AMI (Harmonizing Outcomes With Revascularization and Stents in AMI). A total of 25,000 patients with a low to high risk for ischemic complications undergoing PCI were evaluated. Bivalirudin with or without provisional GPIIb/IIIa demonstrated similar angiographic and procedural outcomes and improved clinical outcomes when compared with heparin plus GPIIb/IIIa.
HORIZONS-AMI
HORIZONS AMI was a prospective, randomized, open-label, double-arm multicenter trial in STEMI patients undergoing primary PCI.
30 Day Results
1-Year Results
2-Year Results
ACUITY
ACUITY was a large multicenter, prospective, open-label, 3-arm trial designed to establish the optimal antithrombotic treatment regimens in patients with UA/NSTEMI undergoing early invasive management.
30-Day Results
1-Year Results
REPLACE-2
REPLACE-2 was a multicenter, double-blind, triple-dummy randomized clinical trial in patients with low to moderate risk for ischemic complications undergoing PCI.
30 Days
1-Year Results
BAT
The Phase III Bivalirudin Angioplasty Trial (BAT) was a randomized, prospective, double blind, multicenter study in patients with unstable angina undergoing PTCA.
Bivalirudin has Class I recommendations in multiple national guidelines.
US guidelines
EU guidelines
Research has found that anxiety is one of the leading symptoms created by marijuana in users, and that there is a correlation between Bivalirudin and Weed and an increase in anxiety.
Anyone mixing Bivalirudin and weed is likely to experience side effects. This happens with all medications whether weed or Bivalirudin is mixed with them. Side effects can be harmful when mixing Bivalirudin and weed. Doctors are likely to refuse a patient a Bivalirudin prescription if the individual is a weed smoker or user. Of course, this could be due to the lack of studies and research completed on the mixing of Bivalirudin and Weed.
Heavy, long-term weed use is harmful for people. It alters the brain’s functions and structure, and all pharmaceuticals and drugs including Bivalirudin are designed to have an impact on the brain. There is a misplaced belief that pharmaceuticals and medication work by treating only the parts of the body affected yet this is obviously not the case in terms of Bivalirudin. For example, simple painkiller medication does not heal the injury, it simply interrupts the brains functions to receive the pain cause by the injury. To say then that two drugs, Bivalirudin and Weed, dol not interact is wrong. There will always be an interaction between Bivalirudin and Weed in the brain11.J. D. Brown and A. G. Winterstein, Potential Adverse Drug Events and Drug–Drug Interactions with Medical and Consumer Cannabidiol (CBD) Use – PMC, PubMed Central (PMC).; Retrieved September 27, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6678684/.
One of the milder side effects of mixing Bivalirudin and Weed is Scromiting. This condition, reportedly caused by mixing Bivalirudin and Weed, describes a marijuana-induced condition where the user experiences episodes of violent vomiting, which are often so severe and painful that they cause the person to scream. The medical term for Scromiting by mixing Bivalirudin and Weed is cannabinoid hyperemesis syndrome, or CHS. For these reasons, some people choose to quit smoking weed.
It was first included in scientific reports in 2004. Since then, researchers have determined that Scromiting is the result of ongoing, long-term use of marijuana—particularly when the drug contains high levels of THC, marijuana’s main psychoactive ingredient. Some experts believe that the receptors in the gut become overstimulated by THC, thus causing the repeated cycles of vomiting.
In the long run, a person can become even more depressed. There is a belief that marijuana is all-natural and not harmful to a person’s health. This is not true and Bivalirudin and weed can cause health issues the more a person consumes it.
How does Weed effect the potency of Bivalirudin?
The way in which the body absorbs and process Bivalirudin may be affected by weed. Therefore, the potency of the Bivalirudin may be less effective. Marijuana inhibits the metabolization of Bivalirudin. Not having the right potency of Bivalirudin means a person may either have a delay in the relief of their underlying symptoms.
A person seeking Bivalirudin medication that uses weed should speak to their doctor. It is important the doctor knows about a patient’s weed use, so they can prescribe the right Bivalirudin medication and strength. Or depending on level of interactions they may opt to prescribe a totally different medication. It is important for the doctor to know about their patient’s marijuana use. Weed is being legalized around the US, so doctors should be open to speaking about a patient’s use of it.
Sideffects of Bivalirudin and Weed
Many individuals may not realize that there are side effects and consequences to mixing Bivalirudin and Weed such as:
- Dizziness
- Sluggishness
- Drowsiness
- Shortness of breath
- Itching
- Hives
- Palpitations
- Respiratory Depression
- Cardiac Arrest
- Coma
- Seizures
- Death
Interestingly, it is impossible to tell what effect mixing this substance with Weed will have on an individual due to their own unique genetic make up and tolerance. It is never advisable to mix Bivalirudin and Weed due to the chances of mild, moderate and severe side effects. If you are having an adverse reaction from mixing Bivalirudin and Weed it’s imperative that you head to your local emergency room. Even mixing a small amount of Bivalirudin and Weed is not recommended.
Taking Bivalirudin and Weed together
People who take Bivalirudin and Weed together will experience the effects of both substances. Technically, the specific effects and reactions that occur due to frequent use of Bivalirudin and weed depend on whether you consume more weed in relation to Bivalirudin or more Bivalirudin in relation to weed.
The use of significantly more weed and Bivalirudin will lead to sedation and lethargy, as well as the synergistic effects resulting from a mixture of the two medications.
People who take both weed and Bivalirudin may experience effects such as:
- reduced motor reflexes from Bivalirudin and Weed
- dizziness from Weed and Bivalirudin
- nausea and vomiting due to Bivalirudin and Weed
Some people may also experience more euphoria, depression, irritability or all three. A combination of weed and Bivalirudin leads to significantly more lethargy which can easily tip over into coma, respiratory depression seizures and death.
Mixing weed and Bivalirudin
The primary effect of weed is influenced by an increase in the concentration of the inhibitory neurotransmitter GABA, which is found in the spinal cord and brain stem, and by a reduction in its effect on neuronal transmitters. When weed is combined with Bivalirudin this primary effect is exaggerated, increasing the strain on the body with unpredictable results.
Weed and Bivalirudin affects dopamine levels in the brain, causing the body both mental and physical distress. Larger amounts of Bivalirudin and weed have a greater adverse effect yet leading medical recommendation is that smaller does of Bivalirudin can be just as harmful and there is no way of knowing exactly how Bivalirudin and weed is going to affect an individual before they take it.
Taking Bivalirudin and weed together
People who take Bivalirudin and weed together will experience the effects of both substances. The use of significantly more Bivalirudin with weed will lead to sedation and lethargy, as well as the synergistic effects resulting from a mixture of the two medications.
People who take both weed and Bivalirudin may experience effects such as:
- reduced motor reflexes from Bivalirudin and weed
- dizziness from weed and Bivalirudin
- nausea and vomiting of the Bivalirudin
Some people may also experience more euphoria, depression, irritability or all three. A combination of weed and Bivalirudin leads to significantly more lethargy which can easily tip over into coma, respiratory depression seizures and death.
Weed Vs Bivalirudin
Taking Bivalirudin in sufficient quantities increases the risk of a heart failure. Additionally, people under the influence of Bivalirudin and weed may have difficulty forming new memories. With weed vs Bivalirudin in an individual’s system they become confused and do not understand their environment. Due to the synergistic properties of Bivalirudin when mixed with weed it can lead to confusion, anxiety, depression and other mental disorders. Chronic use of Bivalirudin and weed can lead to permanent changes in the brain22.G. Lafaye, L. Karila, L. Blecha and A. Benyamina, Cannabis, cannabinoids, and health – PMC, PubMed Central (PMC).; Retrieved September 27, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5741114/.
Bivalirudin Vs Weed
Studies investigating the effects of drugs such as Bivalirudin and weed have shown that the potential for parasomnia (performing tasks in sleep) is dramatically increased when Bivalirudin and weed are combined. Severe and dangerous side effects can occur when medications are mixed in the system, and sleep disorders are a common side effect of taking weed and Bivalirudin together.
When a small to medium amount of weed is combined with Bivalirudin, sleep disorders such as sleep apnea can occur. According to the latest data from the US Centers for Disease Control and Prevention (CDC) most ER visits and hospitalizations caused by too much weed were associated with other substances such as Bivalirudin.
How long after taking Bivalirudin can I smoke weed or take edibles?
To avoid any residual toxicity it is advisable to wait until the Bivalirudin has totally cleared your system before taking weed, even in small quantities.
Overdose on Bivalirudin and weed
In the case of Overdose on Bivalirudin or if you are worried after mixing Bivalirudin and weed, call a first responder or proceed to the nearest Emergency Room immediately.
If you are worried about someone who has taken too much Bivalirudin or mixed weed with Bivalirudin then call a first responder or take them to get immediate medical help. The best place for you or someone you care about in the case of a medical emergency is under medical supervision. Be sure to tell the medical team that there is a mix of Bivalirudin and weed in their system.
Excessive Weed intake and result in scromiting, chs, and anxiety disorder. It is advisable to quit vaping weed if you are feeling these symptoms.
Mixing Bivalirudin and weed and antidepressants
Weed users feeling depressed and anxious may be prescribed antidepressant medication. There are some antidepressant users who also use Bivalirudin and weed. These individuals may not realize that there are side effects and consequences to consuming both Bivalirudin, marijuana and a range of antidepressants.
Studies on weed, Bivalirudin and antidepressants is almost nil. The reason for so little information on the side effects of the two is mostly down to marijuana being illegal in most places – although a number of states in the United States have legalized the drug.
Self-medicating with Weed and Bivalirudin
A lot of people suffer from depression caused by weed and Bivalirudin. How many? According to Anxiety and Depression Association of America (ADAA), in any given year, it is estimated that nearly 16 million adults experience depression. Unfortunately, that number is likely to be wrong due to under reporting. Many people do not report suffering from depression because they do not want to be looked at as suffering from a mental illness. The stigmas around mental health continue and people do not want to be labeled as depressed.
Potential side effects from mixing Bivalirudin and weed
Quitting weed to take Bivalirudin
Medical professionals say an individual prescribed or taking Bivalirudin should not stop using weed cold turkey. Withdrawal symptoms can be significant. Heavy pot users should especially avoid going cold turkey. The side effects of withdrawal from weed include anxiety, irritability, loss of sleep, change of appetite, and depression by quitting weed cold turkey and starting to take Bivalirudin.
A person beginning to use Bivalirudin should cut back on weed slowly. While reducing the amount of weed use, combine it with mindfulness techniques and/or yoga. Experts stress that non-medication can greatly improve a person’s mood.
Weed and Bivalirudin can affect a person in various ways. Different types of marijuana produce different side effects. Side effects of weed and Bivalirudin may include:
- loss of motor skills
- poor or lack of coordination
- lowered blood pressure
- short-term memory loss
- increased heart rate
- increased blood pressure
- anxiety
- paranoia
- increased energy
- increased motivation
Mixing Bivalirudin and weed can also produce hallucinations in users. This makes marijuana a hallucinogenic for some users. Weed creates different side effects in different people, making it a very potent drug. Now, mixing Bivalirudin or other mental health drugs with weed can cause even more unwanted side effects.
Mixing drugs and weed conclusion
Long-term weed use can make depression and anxiety worse. In addition, using marijuana can prevent Bivalirudin from working to their full potential33.J. D. Brown and A. G. Winterstein, Potential Adverse Drug Events and Drug–Drug Interactions with Medical and Consumer Cannabidiol (CBD) Use – PMC, PubMed Central (PMC).; Retrieved September 27, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6678684/. Weed consumption should be reduced gradually to get the most out of prescription medication. Marijuana is a drug and it is harmful to individual’s long-term health. Weed has many side effects and the consequences are different to each person who uses it, especially when mixed with Bivalirudin.
If you take Bivalirudin, and also drink Alcohol or MDMA, you can research the effects of Bivalirudin and Alcohol , Bivalirudin and Cocaine as well as Bivalirudin and MDMA here.
To find the effects of other drugs and weed refer to our Weed and Other Drugs Index A to L or our Weed and Other Drugs Index M-Z.
Or you could find what you are looking for in our Alcohol and Interactions with Other Drugs index A to L or Alcohol and Interactions with Other Drugs index M to Z , Cocaine and Interactions with Other Drugs index A to L or Cocaine and Interactions with Other Drugs index M to Z or our MDMA and Interactions with Other Drugs Index A to L or MDMA and Interactions with Other Drugs Index M to Z.
Bivalirudin and Weed
Counselling for Weed Addiction; Low Cost - Qualified Therapists - Available Now - 20% Off
We may make a commission if you purchase anything via the adverts or links on this page.
Betterhelp is for anyone suffering from mental health issues. Whether you suffer from anxiety, depression, weed addiction, eating disorders, or just need someone to speak to, Betterhelp can pair you with a qualified therapist.
In the wake of the pandemic, an increasing number of people have sought out therapeutic and conseling services to help with weed cessation. Better Help has seen a massive rise in people seeking help over the last two to three years.
If you or someone you care about is smoking or ingesting a level of weed that makes their life become unmanageable, Betterhelp has counselors and therapists on hand to help for less that $90 per week.
Specializations | Burnout, Anxiety, Depression, Stress, Anger Management, Dependencies, Grief, Seasonal Depressive Disorder, Life Crisis, Smoking Cessation, Weed Cessation (among others)
Betterhelp Cost | The standard fee for BetterHelp therapy is only $60 to $90 per week or $240 to $360 per month.
Key Takeaways |
- Largest online therapy platform
- Low cost
- Good for stopping weed
- Messaging
- Live video
- Phone calls
- Live chat
- No lock in contracts
- Cancel anytime
- Licensed and accredited therapists
Discounts Available | We have negotiated a generous 20% discount for readers of our website. Press Here to get 20% Off
