<p><strong>Renal Impairment</strong>: The clearance of Bivalirudin was reduced approximately 20% in patients with moderate and severe renal impairment and was reduced approximately 80% in dialysis-dependent patients.The infusion dose of Bivalirudin may need to be reduced, and anticoagulant status monitored in patients with renal impairment</p>

<ul>
	<li><strong>ClCr 30 to 50 mL/min</strong>: Administer infusion at rate of 1.75 mg/kg/h.</li>
	<li><strong>ClCr less than 30 mL/min</strong>: Reduce infusion rate to 1 mg/kg/h.</li>
</ul>

<p><strong>Hemodialysis</strong>: Reduce infusion rate to 0.25 mg/kg/h. No reduction in bolus dose needed.<br />
<br />
<strong>Pediatric Use</strong>: The safety and effectiveness of Bivalirudin in pediatric patients have not been established.<br />
<br />
<strong>Geriatric Use</strong>: Elderly patients experienced more bleeding events than younger patients. Patients treated with Bivalirudin experienced fewer bleeding events in each age stratum, compared to heparin.</p>