Drug General Information (ID: DDI5U2QDPK)
Drug Name			Bivalirudin		Drug Info		Streptokinase		Drug Info
Drug Type		Small molecule				Protein/peptide
Therapeutic Class		Antithrombotic Agents				Thrombolytics
Structure

Mechanism of Bivalirudin-Streptokinase Interaction (Severity Level: Major)
Increased risk of bleeding Click to Show/Hide Mechanism Graph
Drug Name		Bivalirudin				Streptokinase
Mechanism		Risk of bleeding Anticoagulant				Risk of bleeding Thrombolytic agent
Key Mechanism Factor 1
		Factor Name		Bleeding
		Factor Description		Patients may be at risk for bleeding when the outcome of a disease or disease treatment confounds the standard mechanisms for maintaining hemostasis. Signs or symptoms of abnormal bleeding include: bleeding that takes a long time to stop (including nosebleeds, bleeding gums, bleeding from cuts and abrasions, and menstrual bleeding); severe unexplained bruising, or bruising that becomes larger; blood in the urine or stool, etc.
Mechanism Description		Increased risk of bleeding by the combination of Bivalirudin and Streptokinase

Recommended Action
Management		Coadministration should be undertaken with caution and only after thorough assessment of risks and benefits. Close clinical and laboratory observation for bleeding complications is recommended.

References
1	Product Information. Acova (argatroban) SmithKline Beecham, Philadelphia, PA.
2	Product Information. Angiomax (bivalirudin) The Medicines Compny, Cambridge, MA.
3	Product Information. Refludan (lepirudin). Hoechst Marion-Roussel Inc, Kansas City, MO.