Desirudin
Also known as: CGP-39393, desirudin sodium, Desulfatohirudin, Hirudin variant-1, hirudin‑variant‑1, Iprivask, Revasc
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Summary
Desirudin is a recombinant 34‑amino‑acid hirudin analogue used as a subcutaneous anticoagulant for prophylaxis of deep‑vein thrombosis after orthopedic surgery.
Mechanism of Action
Binds the active site of thrombin, directly inhibiting its proteolytic activity and preventing fibrin formation.
Routes of Administration
Goals & Uses
- Acute coronary syndrome anticoagulationAnticoagulationLow
- Treatment of acute DVT/PETreatmentModerate
- Prevention of pulmonary embolismAnticoagulationModerate
- DVT prophylaxis after orthopedic surgeryPreventionHigh
- Heparin-induced thrombocytopenia (HIT) anticoagulationAnticoagulationModerate
- DVT prophylaxis after hip replacementAnticoagulation / ThromboprophylaxisHigh
Contraindications
- Known hypersensitivity to desirudin or any excipientAllergyHigh
- Spinal/epidural anesthesia with concurrent anticoagulant useAnestheticHigh
- Active major bleedingHemorrhagic RiskHigh
- Severe hepatic impairment (Child‑Pugh C)Liver DiseaseModerate
- Hypersensitivity to hirudins or desirudinImmunologicHigh
- Severe renal impairment (CrCl <31 mL/min)RenalHigh
- Irreversible coagulation disordersHematologicHigh
- Active bleeding or hemorrhagic diathesisHematologicHigh
Adverse Effects
- Hypersensitivity / allergic reactionsImmunologicRare
- Injection site reactionsLocalCommon
- ThrombocytopeniaHematologicRareLow platelet count
- Bleeding (major and minor)HematologicalCommon
- AnemiaHematologicCommonLow red blood cell count or hemoglobin
- Thrombosis (paradoxical)VascularRare
- NauseaGastrointestinalUncommonFeeling of sickness or urge to vomit
- Injection‑site reactionsLocalCommon
- BleedingHematologicCommonAbnormal bleeding or hemorrhage
- Hypersensitivity (urticaria, anaphylaxis)ImmuneRare
Drug Interactions
- Antiplatelet agents (aspirin, clopidogrel)Moderate
- Non‑steroidal anti‑inflammatory drugs (NSAIDs)Moderate
- DextranModerate
- Heparin / Low-molecular-weight heparinsHigh
- WarfarinHigh
- NSAIDs / Antiplatelet agents (e.g., aspirin, clopidogrel)Moderate
- Heparin (unfractionated or low‑molecular‑weight)High
- Thrombolytics (e.g., alteplase)High
Population Constraints
- Pregnancy (Category C)ReproductiveRelative
- PregnancyReproductive SafetyRelative
- Hepatic impairmentOrgan FunctionRelative
- Pediatric patients (<18 y)AgeAbsolute
- Renal impairment (moderate to severe)RenalAbsolute
- Elderly patientsAgeRelative
- Severe renal impairment (CrCl <30 mL/min)Organ ImpairmentRelative
- Patients with prior hirudin exposureImmunologicRelative
Regulatory Status
- European UnionApprovedApproved: Prophylaxis of DVT after orthopedic surgeryEMA‑approved; marketed under Iprivask.
- United StatesApprovedApproved: Prophylaxis of deep‑vein thrombosis after total knee replacementFDA‑approved, prescription‑only.
- United KingdomApprovedApproved: Prophylaxis of deep vein thrombosis following hip replacement surgeryPreviously available under Revasc brand; current commercial availability subject to change post-Brexit
FDA‑approved (2003) as Iprivask for DVT prophylaxis after total knee replacement; also approved in the EU for the same indication.
Evidence & Sources
No sources recorded yet.
Frequently Asked Questions
What is Desirudin?
Desirudin is a recombinant 34‑amino‑acid hirudin analogue used as a subcutaneous anticoagulant for prophylaxis of deep‑vein thrombosis after orthopedic surgery.
What is Desirudin used for?
Desirudin is educationally associated with: Acute coronary syndrome anticoagulation, Treatment of acute DVT/PE, Prevention of pulmonary embolism, DVT prophylaxis after orthopedic surgery, Heparin-induced thrombocytopenia (HIT) anticoagulation, DVT prophylaxis after hip replacement. Educational only — not medical advice.
How is Desirudin administered?
Recorded routes of administration: Subcutaneous.
What are the potential side effects of Desirudin?
Reported adverse effects include: Hypersensitivity / allergic reactions, Injection site reactions, Thrombocytopenia, Bleeding (major and minor), Anemia, Thrombosis (paradoxical), Nausea, Injection‑site reactions, Bleeding, Hypersensitivity (urticaria, anaphylaxis). This list is not exhaustive — consult a qualified clinician.
Who should avoid Desirudin?
Recorded contraindications: Known hypersensitivity to desirudin or any excipient, Spinal/epidural anesthesia with concurrent anticoagulant use, Active major bleeding, Severe hepatic impairment (Child‑Pugh C), Hypersensitivity to hirudins or desirudin, Severe renal impairment (CrCl <31 mL/min), Irreversible coagulation disorders, Active bleeding or hemorrhagic diathesis. Consult a qualified clinician before use.