Classes
DEA Class; Discontinued
Common Brand Names; Iprivask
- Anticoagulants, Hematologic;
- Thrombin Inhibitors
Description
Parenteral recombinant analog of thrombin inhibitor hirudin; used for preventing DVT in patients undergoing elective hip replacement surgery; studied for acute coronary syndromes.
Indications
Indicated for deep venous thrombosis (DVT) prophylaxis in patients undergoing elective hip replacement surgery.
Contraindications
Hypersensitivity
Active bleeding or irreversible coagulation disorders
Adverse Effects
Hemorrhage (1-3%)
Injection site mass (4%)
Wound secretion (4%)
Serious hemorrhage (3%)
Anemia (3%)
Deep thrombophlebitis (2%)
Nausea (2%)
Allergic reaction (2%)
Major hemorrhage
Hypotension
Leg edema
Fever
Decreased hemoglobin
Hematuria
Dizziness
Epistaxis
Vomiting
Impaired healing
Cerebrovascular disorder
Leg pain
Hematemesis
Hematuria
Leg edema
Warnings
Renal impairment (decrease dose)
Increased hemorrhage risk (eg, recent surgery, biopsy, major vessel venipuncture, hemorrhagic stroke, retinopathy, GI bleed)
Spinal or epidural anesthesia
Advanced age (>75 years)
May develop antibodies with reexposure
Prolongs thrombin-dependent coagulation assays (eg, aPTT, thrombin time [TT])
Any agent which may enhance the risk of hemorrhage should be discontinued prior to initiation of desirudin therapy (eg, Dextran 40, systemic glucocorticoids, thrombolytics, and anticoagulants)
Caution when coadministered with drugs that affect platelet function (eg, salicylates, NSAIDS, acetylsalicylic acid, ticlopidine, dipyridamole, sulfinpyrazone, clopidogrel, and glycoprotein IIb/IIIa antagonists [eg, abciximab])
Pregnancy and Lactation
Pregnancy Category: C
Lactation: Unknown whether distributed in breast milk, caution advised
Maximum Dosage
>= 80 mg/day subcutaneously or > 0.1 mg/kg/hour IV is associated with unacceptable rates of bleeding for some indications.
>= 80 mg/day subcutaneously or > 0.1 mg/kg/hour IV is associated with unacceptable rates of bleeding for some indications.
Safety and efficacy have not been established.
Safety and efficacy have not been established.
How supplied
Desirudin
Discontinued
