lepirudin (Intravenous route)

lep-i-ROO-din

Commonly used brand name(s)

In the U.S.

  • Refludan

Available Dosage Forms:

  • Powder for Solution

Therapeutic Class: Anticoagulant

Pharmacologic Class: Thrombin Inhibitor, Direct

Chemical Class: Hirudin Related

Uses For lepirudin

Lepirudin injection is used to decrease the clotting ability of the blood and to help prevent harmful clots from forming in the blood vessels. lepirudin is used to treat or prevent blood clots in patients with bleeding problems caused by another medicine called heparin.

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lepirudin was available only with your doctor's prescription.

Baxter Healthcare Corporation has made a decision to discontinue Refludan (lepirudin (rDNA)) for Injection. No further product will be distributed from Bayer after May 31, 2012.

Before Using lepirudin

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For lepirudin, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to lepirudin or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of lepirudin injection in the pediatric population. Safety and efficacy have not been established.

Geriatric

No information is available on the relationship of age to the effects of lepirudin injection in geriatric patients.

Pregnancy

Pregnancy Category Explanation
All Trimesters B Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving lepirudin, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using lepirudin with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Abciximab
  • Acenocoumarol
  • Alteplase, Recombinant
  • Anistreplase
  • Argatroban
  • Bivalirudin
  • Bromfenac
  • Celecoxib
  • Clopidogrel
  • Dabigatran Etexilate
  • Dalteparin
  • Danaparoid
  • Diclofenac
  • Diflunisal
  • Dipyridamole
  • Drotrecogin Alfa
  • Enoxaparin
  • Eptifibatide
  • Etodolac
  • Flurbiprofen
  • Ibuprofen
  • Ibuprofen Lysine
  • Indomethacin
  • Ketoprofen
  • Ketorolac
  • Lepirudin
  • Magnesium Salicylate
  • Mefenamic Acid
  • Meloxicam
  • Nabumetone
  • Naproxen
  • Nepafenac
  • Oxaprozin
  • Phenindione
  • Phenprocoumon
  • Piroxicam
  • Reteplase, Recombinant
  • Rivaroxaban
  • Salsalate
  • Streptokinase
  • Sulindac
  • Tenecteplase
  • Ticlopidine
  • Tinzaparin
  • Tirofiban
  • Tolmetin
  • Urokinase
  • Warfarin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of lepirudin. Make sure you tell your doctor if you have any other medical problems, especially:

  • Bacterial endocarditis (heart infection) or
  • Blood disease or bleeding problems or
  • Blood vessel problems or
  • Hypertension (high blood pressure), severe and uncontrolled or
  • Kidney disease or
  • Major surgery or procedure (e.g., biopsy, brain surgery), recent or
  • Spinal anesthesia or
  • Stomach or intestinal ulcer, active or
  • Stroke, recent—Use with caution. The risk of bleeding may be increased.
  • Liver disease (e.g., cirrhosis)—May increase the effect of lepirudin in the body.

Proper Use of lepirudin

A nurse or other trained health professional will give you lepirudin. lepirudin is given through a needle placed into one of your veins.

Precautions While Using lepirudin

lepirudin will only be given to you while you are in the hospital. Before you leave the hospital, you may be switched to an oral medicine that works in a similar way. If you have any concerns about this, talk to your doctor.

It is very important that your doctor check you at regular visits after you leave the hospital for any problems or unwanted effects that may be caused by lepirudin. Be sure to keep all appointments.

lepirudin may cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Tell your doctor right away if you have a rash, itching, swelling of the face, tongue, and throat, trouble breathing, or chest pain after you get the injection.

lepirudin may increase your chance of bleeding. Check with your doctor right away if you notice any unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, or pinpoint red spots on your skin. Avoid picking your nose. If you need to blow your nose, blow it gently.

lepirudin Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common
  • Bleeding from puncture sites and wounds
  • blood in the urine
  • bloody or black, tarry stools
  • collection of blood under the skin
  • constipation
  • dark urine
  • deep, dark purple bruise
  • fever with or without chills
  • itching, pain, redness, or swelling
  • light-colored stools
  • loss of appetite
  • nausea and vomiting
  • pale skin
  • severe stomach pain
  • troubled breathing with exertion
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • vomiting of blood or material that looks like coffee grounds
  • yellow eyes or skin
Less common
  • Bloody nose
  • chest pain or discomfort
  • cloudy urine
  • confusion
  • cough or hoarseness
  • decrease in urine output
  • difficult or labored breathing
  • dilated neck veins
  • dizziness
  • extreme fatigue
  • fainting
  • fast, slow, or irregular heartbeat
  • headache, sudden and severe
  • irregular breathing
  • lightheadedness
  • lower back or side pain
  • noisy breathing
  • painful or difficult urination
  • rapid, shallow breathing
  • shortness of breath
  • skin rash, hives, itching, or redness
  • sneezing
  • sore throat
  • swelling of the face, fingers, feet, or lower legs
  • tightness in the chest
  • troubled breathing
  • vaginal bleeding
  • weakness
  • weight gain
  • wheezing
Rare
  • Difficulty swallowing
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • tightness or swelling of the neck

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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