Drug Interactions between lepirudin and prothrombin complex

CONTRAINDICATED: Since direct thrombin inhibitors are used for the treatment of thrombosis in patients with heparin-induced thrombocytopenia (HIT) and for anticoagulation in patients with or at risk for HIT, heparin-containing products such as prothrombin complex would not be indicated in these patients.

MANAGEMENT: Patients with known HIT should not receive prothrombin complex because it contains heparin. All formulations with heparin, including heparin lock flush, should be withdrawn prior to and during the treatment of heparin-induced thrombocytopenia. Clinicians should allow sufficient time for heparin's effect on the activated partial thromboplastin time (aPTT) to decrease prior to initiation of the thrombin inhibitor. Close clinical and laboratory observation for bleeding complications is recommended.