desirudin (Discontinued)

Brand and Other Names:Iprivask
  • Print

Dosing & Uses

AdultPediatric

Product discontinued in United States

Safety and efficacy not established

Next:

Interactions

Interaction Checker

and desirudin

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 
            Previous
            Next:

            Adverse Effects

            1-10%

            Hemorrhage (1-3%)

            Injection site mass (4%)

            Wound secretion (4%)

            Serious hemorrhage (3%)

            Anemia (3%)

            Deep thrombophlebitis (2%)

            Nausea (2%)

            Allergic reaction (2%)

            <1%

            Major hemorrhage

            Hypotension

            Leg edema

            Fever

            Decreased hemoglobin

            Hematuria

            Dizziness

            Epistaxis

            Vomiting

            Impaired healing

            Cerebrovascular disorder

            Leg pain

            Hematemesis

            Hematuria

            Leg edema

            Previous
            Next:

            Warnings

            Black Box Warnings

            Epidural or spinal hematomas may occur if receiving neuraxial anesthesia (ie, epidural/spinal anesthesia) or with spinal puncture

            These hematomas may result in long-term or permanent paralysis

            When scheduling patient for spinal procedures, thoroughly evaluate risk and consider other forms of anesthesia

            Risk Factors

            • Indwelling epidural catheters
            • Coadministration with drugs that affect hemostasis (eg, NSAIDs, platelet inhibitors, other anticoagulants)
            • History of traumatic or repeated epidural or spinal punctures
            • History of spinal deformity or spinal surgery

            Monitor for signs and symptoms of neurological impairment; urgent treatment required if neurologic compromise observed

            Contraindications

            Hypersensitivity

            Active bleeding or irreversible coagulation disorders

            Cautions

            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])

            Previous
            Next:

            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: Unknown whether distributed in breast milk, caution advised

            Pregnancy Categories

            A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA: Information not available.

            Previous
            Next:

            Pharmacology

            Mechanism of Action

            Recombinant hirudin product; selective inhibitor of free circulating and clot-bound human thrombin, with protein structures similar to naturally occurring hirudin (an anticoagulant present in medicinal leeches)

            Inhibits activation of thrombin-induced platelet aggregation, coagulation factors V, VII, and XIII, which in turn results in prolongation of the activated partial thromboplastin time

            Pharmacokinetics

            Half-Life: 2-4 hr

            Vd: 25 L/kg

            Peak Plasma Time: 1-3 hr

            Clearance: 1.5-2.7 mL/min/kg

            Excretion: Unchanged in urine (40-50%)

            Previous
            Next:

            Images

            Previous
            Next:
            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.