A synopsis of the clinical uses of argatroban

Argatroban, a direct thrombin inhibitor, has been used in Japan since the e arly 1980's and was recently approved for use in the United States for pati ents with heparin-induced thrombocytopenia. However, its use has been studi ed in other clinical settings including, myocardial infarction, percutaneou s coronary intervention and cerebral thrombosis. The doses used in the diff erent clinical situations vary, but argatroban offers the advantage of not requiring renal adjustment. Because of its small molecular weight, argatrob an has the ability to inhibit both clot bound and soluble thrombin. This pa per provides a comprehensive review of both indicated and off label uses of argatroban. Pharmacology, pharmacokinetics, adverse events and drug intera ctions with argatroban are also discussed.