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Generic Name: lepirudin (LEP i roo din)
Brand Name: Refludan

What is lepirudin?

Lepirudin helps to prevent platelets in your blood from sticking together and forming a blood clot.

Lepirudin is used to treat or prevent blood clots that can occur after using heparin, or with certain blood vessel conditions.

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

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

Lepirudin increases your risk of bleeding, which can be severe or life-threatening. Avoid activities that may increase your risk of bleeding or injury.

Call your doctor or seek emergency medical attention if you have bleeding that will not stop. You may also have bleeding on the inside of your body, such as in your stomach or intestines. Call your doctor at once if you have black or bloody stools, or if you cough up blood or vomit that looks like coffee grounds. These could be signs of bleeding in your digestive tract.

What should I discuss with my health care provider before receiving lepirudin?

You should not use this medicine if you are allergic to lepirudin, or to a similar medicine called bivalirudin (Angiomax).

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

  • kidney disease (or if you are on dialysis);

  • liver disease (especially cirrhosis);

  • any major bleeding from a surgery, injury, or other medical trauma;

  • a bleeding or blood clotting disorder such as hemophilia;

  • infection of the lining of your heart (also called bacterial endocarditis);

  • untreated or uncontrolled high blood pressure;

  • a stomach ulcer or bleeding, intestinal bleeding;

  • a recent history of stroke, heart attack, brain surgery, spinal surgery, spinal tap, or epidural anesthesia;

  • if you have recently had an intravenous (IV) catheter; or

  • if you recently had a biopsy of any of your organs.

This medicine is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether lepirudin passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.

How is lepirudin given?

Lepirudin is injected into a vein through an IV. A healthcare provider will give you this injection.

You will need frequent medical tests to help your doctor determine how long to treat you with lepirudin.

Because lepirudin keeps your blood from coagulating (clotting) to prevent unwanted blood clots, it can also make it easier for you to bleed, even from a minor injury. Contact your doctor or seek emergency medical attention if you have bleeding that will not stop.

What happens if I miss a dose?

Because you will receive lepirudin in a clinical setting, you are not likely to miss a dose.

What happens if I overdose?

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

Overdose may cause severe bleeding.

What should I avoid while receiving lepirudin?

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

Lepirudin side effects

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

Lepirudin increases your risk of bleeding, which can be severe or life-threatening. Call your doctor at once or seek emergency medical attention if you have:

  • a light-headed feeling, like you might pass out;

  • easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

  • sudden numbness or weakness (especially on one side of the body), sudden headache, confusion, problems with speech, or balance;

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

  • red or pink urine;

  • bleeding from an injury or needle puncture; or

  • any bleeding that will not stop.

Bleeding is the most common side effect of lepirudin.

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)

Lepirudin dosing information

Usual Adult Dose for Thrombocytopenia Drug Induced:

Heparin-induced thrombocytopenia:
Initial dose: 0.4 mg/kg IV (max 44 mg) slowly (over 15 to 20 seconds) followed by 0.15 mg/kg/hr IV (max 16.5 mg/hr) continuous infusion for 2 to 10 days or longer if clinically needed.

What other drugs will affect lepirudin?

Tell your doctor about all your current medicines and any you start or stop using, especially other medicines used to prevent blood clots, such as:

  • bivalirudin, dabigatran, desirudin;

  • fondaparinux, rivaroxaban; or

  • heparin, dalteparin, enoxaparin, tinzaparin.

This list is not complete. Other drugs may interact with lepirudin, 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 doctor or pharmacist can provide more information about lepirudin.
  • 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: 2.02. Revision Date: 2015-08-17, 4:36:23 PM.