Bivalirudin vs LL-37
Overview
Bivalirudin is primarily a cardiovascular peptide, while LL-37 is used for immune support.
This page compares Bivalirudin and LL-37 across their primary use, typical dosing, reported benefits and side effects, and U.S. regulatory status. For the full monograph on either compound — mechanism of action, clinical research, and references — follow the article links.
Side-by-side comparison
| Bivalirudin | LL-37 | |
|---|---|---|
| Category | Cardiovascular | Immune Support |
| Regulatory status (US) | FDA approved | Compounding (Rx) — Apr 2026 |
| Typical dosage | 0.75 mg/kg IV bolus, then 1.75 mg/kg/h IV infusion | 2-5 mg |
| Frequency | Single procedural session: bolus immediately before PCI followed by continuous infusion during the procedure; optional post-procedural infusion for up to approximately 20 hours | twice weekly |
| Reported benefits | Anticoagulation during PCI and PTCA, anticoagulation in HIT/HITTS patients undergoing PCI, reduced major bleeding versus heparin plus glycoprotein IIb/IIIa inhibitor, predictable pharmacokinetics without need for antithrombin cofactor, rapid offset of anticoagulation due to short half-life, inhibition of both circulating and clot-bound thrombin | Antimicrobial activity, immune modulation, wound healing, anti-inflammatory |
| Reported side effects | Bleeding (most common, including access-site and retroperitoneal), acute stent thrombosis (early, within 24 hours), back pain, nausea, headache, hypotension, injection-site pain, hypersensitivity reactions, thrombocytopenia (rare) | Generally safe, minimal side effects |
Key differences
Primary use. Bivalirudin is categorised under Cardiovascular, while LL-37 falls under Immune Support. Their differing categories mean they are usually chosen for different goals rather than as direct substitutes.
Regulatory status. Bivalirudin: FDA-approved. LL-37: not FDA-approved; compounding permitted with a prescription as of April 2026.
Dosing. Bivalirudin is typically dosed at 0.75 mg/kg IV bolus, then 1.75 mg/kg/h IV infusion (Single procedural session: bolus immediately before PCI followed by continuous infusion during the procedure; optional post-procedural infusion for up to approximately 20 hours). LL-37 is typically dosed at 2-5 mg (twice weekly).
Can you stack them?
Some protocols combine peptides, but stacking Bivalirudin and LL-37 has not been validated for safety or efficacy in controlled trials. Combining compounds can change their effects and risks. Nothing here is medical advice — consult a qualified healthcare provider before starting or combining any protocol.
Frequently asked questions
- What is the difference between Bivalirudin and LL-37?
- Bivalirudin is primarily a cardiovascular peptide, while LL-37 is used for immune support. Bivalirudin is FDA-approved for one or more indications, whereas LL-37 is not FDA-approved; compounding permitted with a prescription (as of April 2026).
- What is Bivalirudin used for?
- FDA-approved synthetic peptide direct thrombin inhibitor used for anticoagulation during PCI, including in HIT patients.
- What is LL-37 used for?
- Antimicrobial defense peptide.
- Can you take Bivalirudin and LL-37 together?
- Some users combine peptides within a single protocol, but stacking Bivalirudin and LL-37 has not been established as safe or effective in controlled trials. Neither this comparison nor PeptideSciences101 is medical advice — consult a qualified healthcare provider before combining any compounds.
- Is Bivalirudin or LL-37 FDA-approved?
- Bivalirudin is FDA-approved for one or more indications. LL-37 is not FDA-approved; compounding permitted with a prescription (as of April 2026).
Read the full articles
- Bivalirudin — full monograph: mechanism, research, dosing & references
- LL-37 — full monograph: mechanism, research, dosing & references