desirudin

Generic Name: desirudin (DES i ROO din)
Brand Name: Iprivask

What is desirudin?

Desirudin is an anticoagulant (thrombin inhibitor) that helps prevent the formation of blood clots.

Desirudin is used to prevent a type of blood clot called deep vein thrombosis (DVT), which can lead to blood clots in the lungs (pulmonary embolism). A DVT can occur after certain types of surgery. Desirudin is for use after hip replacement surgery.

Desirudin may also be used for purposes not listed in this medication guide.

What is the most important information I should know about desirudin?

You should not use this medicine if you have active or uncontrolled bleeding, or an irreversible blood clotting disorder.

Desirudin can cause a very serious blood clot around your spinal cord if you undergo a spinal tap or receive spinal anesthesia (epidural), especially if you are also using other drugs that can affect blood clotting, including blood thinners or NSAIDs (ibuprofen, Advil, Aleve, and others). This type of blood clot can lead to long-term or permanent paralysis.

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Get emergency medical help if you have symptoms of a spinal cord blood clot such as back pain, numbness or muscle weakness in your lower body, or loss of bladder or bowel control.

What should I discuss with my healthcare provider before using desirudin?

You should not use this medicine if you are allergic to desirudin, bivalirudin, or lepirudin, or if you have:

  • active or uncontrolled bleeding; or

  • an irreversible blood clotting disorder.

Desirudin can cause a very serious blood clot around your spinal cord if you undergo a spinal tap or receive spinal anesthesia (epidural). This type of blood clot could cause long-term or permanent paralysis, and may be more likely to occur if:

  • you have a spinal cord injury;

  • you have a spinal catheter in place;

  • you have a history of spinal surgery or repeated spinal taps;

  • you are taking an NSAID (nonsteroidal anti-inflammatory drug)--ibuprofen (Advil, Motrin), naproxen (Aleve), diclofenac, indomethacin, meloxicam, and others; or

  • you are using a blood thinner (warfarin, Coumadin) or other medicines to treat or prevent blood clots.

To make sure desirudin is safe for you, tell your doctor if you have:

  • kidney disease; or

  • cirrhosis or other liver disease.

Desirudin may cause you to bleed more easily, especially if you have:

  • a bleeding disorder that is inherited or caused by disease;

  • a history of hemorrhagic stroke;

  • uncontrolled high blood pressure;

  • bleeding inside your head;

  • eye problems caused by diabetes;

  • if you have had bleeding in your lungs, stomach, or intestines within the past 3 months;

  • if you have recently had surgery, an organ transplant, or biopsy of an organ; or

  • if you take steroid medicine (prednisone, dexamethasone, and others), or a salicylate (aspirin, choline salicylate, diflunisal, magnesium salicylate, salsalate, and others).

FDA pregnancy category C. It is not known whether desirudin will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine.

It is not known whether desirudin passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How is desirudin given?

Desirudin is usually given every 12 hours for up to 12 days after your surgery. Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Desirudin is injected under the skin. You may be shown how to use injections at home. Do not self inject this medicine if you do not understand how to give the injection and properly dispose of used needles and syringes.

Desirudin is a powder medicine that must be mixed with a liquid (diluent) before using it. If you are using the injections at home, be sure you understand how to properly mix and store the medicine. Use only the syringe and needle provided with this medicine.

Use a different place on your stomach or thigh each time you give the injection. Your care provider will show you the best places on your body to inject the medication. Do not inject into the same place two times in a row.

Use a disposable needle only once. Follow any state or local laws about throwing away used needles and syringes. Use a puncture-proof "sharps" disposal container (ask your pharmacist where to get one and how to throw it away). Keep this container out of the reach of children and pets.

While using desirudin, you may need frequent blood tests.

Store the powder and diluent at cool room temperature away from moisture, heat, and light. After mixing desirudin, store it at room temperature and use within 24 hours.

What happens if I miss a dose?

Call your doctor for instructions if you miss a dose of desirudin.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose may cause excessive bleeding.

What should I avoid while using desirudin?

Avoid rubbing your skin after injecting this medicine, to prevent bruising.

Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.

Desirudin side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Also seek emergency medical attention if you have symptoms of a spinal blood clot: back pain, numbness or muscle weakness in your lower body, or loss of bladder or bowel control.

Call your doctor at once if you have:

  • easy bruising or bleeding (nosebleeds, bleeding gums, heavy menstrual bleeding);

  • pain, swelling, or drainage from a wound or where a needle was injected in your skin;

  • bleeding from wounds or needle injections, any bleeding that will not stop;

  • headache, dizziness, weakness, feeling like you might pass out;

  • urine that looks red, pink, or brown; or

  • bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds.

Serious side effects may be more likely in adults who are 75 years or older.

Common side effects may include:

  • nausea;

  • vomiting; or

  • fever.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Desirudin dosing information

Usual Adult Dose for Deep Vein Thrombosis -- Prophylaxis:

15 mg subcutaneously every 12 hours with the initial dose given up to 5 to 15 minutes prior to surgery, but after induction of regional block anesthesia (if used).

Up to 12 days administration (9 to 12 days on average) of desirudin has been well tolerated in controlled clinical trials.

What other drugs will affect desirudin?

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with desirudin, especially other medicines used to treat or prevent blood clots, such as:

  • abciximab, clopidogrel, dipyridamole, eptifibatide, ticlopidine, tirofiban;

  • alteplase, reteplase, tenecteplase, urokinase;

  • argatroban, bivalirudin, dabigatran, fondaparinux, lepirudin, rivaroxaban; or

  • dalteparin, enoxaparin, heparin, tinzaparin.

This list is not complete. Other drugs may interact with desirudin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about desirudin.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 1.02. Revision Date: 2014-04-13, 8:02:12 PM.

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