Lepirudin Side Effects

Brand Names: Refludan

Please note - some side effects for Lepirudin may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA at http://www.fda.gov/medwatch/ or 1-800-FDA-1088 (1-800-332-1088).

Side Effects of Lepirudin - for the Consumer

Lepirudin

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Lepirudin:

Redness or discomfort at the injection site.

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); black or bloody stools; confusion; dark urine; easy bruising or bleeding; fever; nausea or vomiting; one-sided weakness; slurred speech; vision problems; vomit that looks like coffee grounds; yellowing eyes or skin.

Side Effects by Body System

Hematologic

Other hemorrhagic events (hemoperitoneum, hemoptysis, liver bleeding, lung bleeding, mouth bleeding, retroperitoneal bleeding) each occurred in one individual among 198 patients treated with lepirudin in controlled trials.

Hemorrhagic events have been the most common and potentially serious side effects associated with the use of lepirudin. The following were reported during controlled trials: bleeding from puncture sites and wounds (10.6% to 14.1%); anemia or isolated drop in hemoglobin concentration (12.4% to 13.1%); hematoma or unclassified hemorrhage (10.6% to 11.1%); gastrointestinal or rectal bleeding (5.1% to 5.3%); epistaxis (3.0% to 4.4%); hemothorax (0% to 3.0%); vaginal bleeding (1.5% to 1.8%); intracranial bleeding (0%). Intracranial hemorrhage (ICH) has been observed in patients with acute myocardial infarction who were started on both thrombolytic therapy and lepirudin. The overall prevalence of ICH in this population was 0.6% (7 of 1134 patients). ICH was not observed among 1168 patients who did not receive concomitant thrombolytic therapy.

Hypersensitivity

Serious anaphylactic reactions resulting in shock or death have been reported.

Hypersensitivity reactions have occurred in up to 10% of patients and have included skin rashes, pruritus, urticaria, flushing, or chills (less than 1.0% to 3.5%) and airway reactions, such as cough, bronchospasm, stridor, dyspnea (up to 10%). Anaphylaxis or anaphylactoid reactions have been observed in less than 1% of patients. Approximately 53% of allergic or suspected allergic reactions occurred in patients also receiving thrombolytic therapy for acute myocardial infarction and/or contrast media for coronary angiography.

Immunologic

Antihirudin antibodies have been reported in approximately 40% of heparin-induced thrombocytopenia patients receiving lepirudin. Complexation of lepirudin to these antibodies may increase the anticoagulant effect due to delayed renal elimination of active complexes. Lepirudin neutralization and allergic reactions have not been reported despite positive antibody tests. Adverse reactions following reexposure have been limited to mild skin reactions.

Respiratory

Respiratory effects as a result of hypersensitivity reactions have been reported in up to 10% of patients. Symptoms included cough, bronchospasm, stridor, and dyspnea. Pneumonia has occurred in up to 4.4% of patients compared with 5.5% in control patients.

Hepatic

Abnormal elevations of liver transaminases and other measurements of liver function have been reported in approximately 6% of patients.

General

General side effects have included fever (4% to 6% of patients) and unspecified allergic reactions (less than 1% of patients).

The prevalence of sepsis, unspecified infections, and multiorgan failure has been similar among treated versus control patients (4.0% versus 5.5%, 2.5% versus 1.1%, and 2.0% versus 0%, respectively).

Cardiovascular

Cardiovascular side effects have included new or worsened heart failure in up to 3% of patients. Pericardial effusion and ventricular fibrillation each have been reported in 1% of patients. Edema (facial, tongue, laryngeal, or angioedema) has been associated rarely with use of lepirudin.

Renal

New or worsened renal insufficiency has been observed in 1.8% to 2.5% of patients versus 4.4% among control patients.

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