Table 2. Agents Used for Type II HIT

Agent	Lepirudin	Argatroban	Danaparoid*
Brand Name	Refludan®	Argatroban®	Orgaran®
Mechanism	Direct thrombin inhibitor	Direct thrombin inhibitor	Accelerates activity of antithrombin III against factor Xa and factor IIa
Dosing	0.4 mg/kg IV bolus followed by infusion of 0.15 mg/kg/hour NOTE: Dose adjustment required in renal insufficiency	Start at 2 mcg/kg/min Dosing can be increased up to a maximum of 10 mcg/kg/min NOTE: Dose adjustment required in hepatic insufficiency	2500 U bolus followed by infusion of 400 U/hour for 4 hours, then 300 U/hour for 4 hours, then maintenance of 150-200 U/hour
Monitoring	aPTT	aPTT Transition to warfarin: At dose of 2 mcg/kg/min   Discontinue infusion,   check INR after 4 to 6   hours after infusion   stopped At dose of >2 mcg/kg/min   Titrate infusion to 2   mcg/kg/min, check INR   after 4 to 6 hours while at   2 mcg/kg/min	Anti-Xa activity monitoring recommended in patients with renal impairment and inpatients <55 and >90 kg
Half-life	40 to 120 minutes	24 to 50 minutes	18 to 28 hours
Reversal agent	None	None	None

* NOT FDA-approved for Type II HIT.

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