Bivalirudin vs TB-500

A side-by-side comparison from PeptideSciences101, the open peptide reference.

Overview

Bivalirudin is primarily a cardiovascular peptide, while TB-500 is used for healing & recovery.

This page compares Bivalirudin and TB-500 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

BivalirudinTB-500
CategoryCardiovascularHealing & Recovery
Regulatory status (US)FDA approvedCompounding (Rx) — Apr 2026
Typical dosage0.75 mg/kg IV bolus, then 1.75 mg/kg/h IV infusion2-5 mg
FrequencySingle procedural session: bolus immediately before PCI followed by continuous infusion during the procedure; optional post-procedural infusion for up to approximately 20 hoursweekly
Reported benefitsAnticoagulation 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 thrombinTissue repair, improved flexibility, reduced inflammation, enhanced recovery, hair growth stimulation
Reported side effectsBleeding (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)Minimal side effects. Rare: headache, nausea, injection site reactions

Key differences

Primary use. Bivalirudin is categorised under Cardiovascular, while TB-500 falls under Healing & Recovery. Their differing categories mean they are usually chosen for different goals rather than as direct substitutes.

Regulatory status. Bivalirudin: FDA-approved. TB-500: 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). TB-500 is typically dosed at 2-5 mg (weekly).

Can you stack them?

Some protocols combine peptides, but stacking Bivalirudin and TB-500 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 TB-500?
Bivalirudin is primarily a cardiovascular peptide, while TB-500 is used for healing & recovery. Bivalirudin is FDA-approved for one or more indications, whereas TB-500 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 TB-500 used for?
Tissue repair, flexibility, inflammation.
Can you take Bivalirudin and TB-500 together?
Some users combine peptides within a single protocol, but stacking Bivalirudin and TB-500 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 TB-500 FDA-approved?
Bivalirudin is FDA-approved for one or more indications. TB-500 is not FDA-approved; compounding permitted with a prescription (as of April 2026).

Read the full articles

  • Bivalirudin — full monograph: mechanism, research, dosing & references
  • TB-500 — full monograph: mechanism, research, dosing & references

Bivalirudin compared across categories

← All peptide comparisons