Desirudin
Information about Desirudin[edit source]
Desirudin is a parenterally administered, selective thrombin inhibitor that is used to decrease the risk of deep vein thrombosis and pulmonary embolus in patients undergoing hip replacement surgery.
Liver safety of Desirudin[edit source]
Desirudin has not been linked to serum enzyme elevations during therapy or to clinically apparent liver injury with jaundice.
Mechanism of action of Desirudin[edit source]
Desirudin (des" i roo' din) is a recombinant 65 amino acid peptide analogue of hirudin, the naturally occurring anticoagulant found in the salivary glands of leeches (Hirudo medicinalis). Hirudin is a mixture of similar peptides that actively bind to and inactivate thrombin. Like human antithrombin, hirudin binds to both circulating and fibrinogen bound thrombin and thus both prevents and dissolves clots and thrombi. In clinical trials, desirudin given during and after hip replacement surgery was equivalent or slightly better than heparin in decreasing the frequency of deep vein thrombosis and pulmonary emboli during the perioperative period. Desirudin was approved for use in the United States in 2003 and has been used in limited numbers of patients.
Current indications are limited to reduction of the risk of deep vein thrombosis and pulmonary embolization after elective hip replacement surgery.
Dosage and administration for Desirudin[edit source]
Desirudin is available in single use vials of 15.75 mg under the commercial name Iprivask. The usual dose is an injection of 15 mg subcutaneously immediately before surgery and twice daily for 8 to 12 days.
Side effects of Desirudin[edit source]
The most common side effect is bleeding; other side effects are not common, but can include hypersensitivity reactions, including anaphylaxis. Hypersensitivity reactions are particularly common and more likely to be severe in persons who have been previously treated with desirudin or other hirudin analogues such as bivalirudin.
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