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Desirudin

    Discontinued

    DEA Class; Discontinued

    Common Brand Names; Iprivask

    • Anticoagulants, Hematologic; 
    • Thrombin Inhibitors

    Parenteral recombinant analog of thrombin inhibitor hirudin; used for preventing DVT in patients undergoing elective hip replacement surgery; studied for acute coronary syndromes.

    Indicated for deep venous thrombosis (DVT) prophylaxis in patients undergoing elective hip replacement surgery.

    For patients with acute coronary syndromes (acute myocardial infarction, NSTEMI; acute myocardial infarction, STEMI; unstable angina).
    For prevention of restenosis after percutaneous transluminal coronary angioplasty (PTCA).

    Hypersensitivity

    Active bleeding or irreversible coagulation disorders

    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

    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 Category: C

    Lactation: Unknown whether distributed in breast milk, caution advised

    Adults

    >= 80 mg/day subcutaneously or > 0.1 mg/kg/hour IV is associated with unacceptable rates of bleeding for some indications.

    Geriatric

    >= 80 mg/day subcutaneously or > 0.1 mg/kg/hour IV is associated with unacceptable rates of bleeding for some indications.

    Adolescents

    Safety and efficacy have not been established.

    Children

    Safety and efficacy have not been established.

    Desirudin

    Discontinued