Dosing of Parenteral Anticoagulants During PCI Drug* In Patients Who Have Received Prior Anticoagulant Therapy In Patients Who Have Not Received Prior Anticoagulant Therapy Enoxaparin For prior treatment with enoxaparin, if last SC dose was administered 8 12 h earlier or if <2 therapeutic SC doses of enoxaparin have been administered, an IV dose of enoxaparin 0.3 mg/kg should be given 0.5 mg/kg-0.75 mg/kg IV loading dose If the last SC dose was administered within prior 8 h, no additional enoxaparin should be given Bivalirudin For patients who have received UFH, wait 30 min, then give 0.75 mg/kg IV loading dose, then 1.75 mg/kg/h IV infusion 0.75 mg/kg loading dose, 1.75 mg/kg/h IV infusion For patients already receiving bivalirudin infusion, give additional loading dose 0.5 mg/kg and increase infusion to 1.75 mg/kg/h during PCI Fondaparinux For prior treatment with fondaparinux, administer additional IV treatment with anticoagulant possessing anti-IIa activity, considering whether GPI receptor antagonists have been administered N/A UFH IV GPI planned: additional UFH as needed (eg, 2000 5000 U) to achieve ACT of 200 250 s IV GPI planned: 50 70 U/kg loading dose to achieve ACT of No IV GPI planned: additional UFH as needed (eg, 2000 5000 U) to achieve ACT of 250 300 s for HemoTec, 300 350 s for Hemochron No IV GPI planned: 70 100 U/kg loading dose to achieve target ACT of 250 300 s for HemoTec, 300 350 s for Hemochron *Drugs presented in order of the COR and then the LOE as noted in the Preamble. When more than 1 drug exists within the same LOE, and there are no comparative data, then the drugs are listed alphabetically. 