Generic Name and Formulations:
Desirudin 15mg/vial; pwd for SC inj after reconstitution; preservative-free; diluent contains mannitol.
Indications for IPRIVASK:
DVT prophylaxis in patients undergoing hip replacement surgery.
Not interchangeable with other hirudins. Give by SC inj, preferably in abdomen or thigh. 15mg every 12hrs starting up to 5–15min before surgery (after induction of regional block anesthesia, if used); may continue for 9–12 days post-op. Renal impairment (CrCl<60mL/min): reduce dose (see full labeling).
Traumatic or repeated neuraxial puncture. Post-op indwelling epidural catheter (place catheter before starting therapy and remove when desirudin effect is low). Hemorrhagic stroke. Recent surgery or biopsy. Diabetic retinopathy. Severe uncontrolled hypertension. Recent GI or pulmonary bleeding. Bacterial endocarditis. Renal impairment: monitor aPTT and serum creatinine closely. Hepatic impairment. Monitor for neurological impairment (may indicate spinal/epidural hematoma). Pregnancy (Cat.C). Nursing mothers.
Concomitant heparins (fractionated or unfractionated): not recommended. Concomitant NSAIDs, platelet inhibitors, other anticoagulants: increased risk of bleeding, neuraxial hematoma with epidural catheters; discontinue these and others that increase bleeding risk (eg, glucocorticoids, Dextran 40) before starting desirudin. Caution with drugs that affect platelets (eg, salicylates, ticlopidine, clopidogrel, abciximab, gp IIb/IIIa antagonists). Switching to or from coumadin: monitor closely.
Direct thrombin inhibitor (recombinant hirudin).
Bleeding, inj site reaction/mass, nausea, anaphylaxis, antibody formation.
Single-use vials—10 (w. diluent, supplies)
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