Argatroban monohydrate is primarily used as an anticoagulant in medical settings. It is particularly effective in preventing blood clots in patients with heparin-induced thrombocytopenia (HIT), a condition where heparin, another anticoagulant, causes a dangerous drop in platelet count. This medication works by directly inhibiting thrombin, a key enzyme in the blood clotting process.

In clinical practice, it is administered intravenously to patients undergoing procedures like angioplasty or those at risk of thrombosis during surgeries. It is also used in intensive care units for patients requiring continuous anticoagulation but who cannot tolerate heparin. Additionally, it is sometimes employed in the management of acute coronary syndromes and deep vein thrombosis when alternative anticoagulants are not suitable.

The drug is carefully monitored to ensure the correct dosage, as improper use can lead to bleeding complications. Its rapid onset and short half-life make it a flexible option for controlling coagulation in critical care scenarios.