Desirudin

CLINICAL USE

Prophylaxis of DVT in patients undergoing orthopaedic surgery

DOSE IN NORMAL RENAL FUNCTION

15 mg 5–15 minutes before surgery then 15 mg twice daily for 9–12 days or until mobile

PHARMACOKINETICS

Molecular weight :6963.4

%Protein binding :No data

%Excreted unchanged in urine : 40–50

Volume of distribution (L/kg) :0.25

half-life – normal/ESRD (hrs) :2–3

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

31–60 Initially 5 mg twice daily. Aim for APTT <0.85 seconds<31 Initially 1.7 mg twice daily and monitor APTT

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Not dialysed. Dose as in GFR<31 mL/min

HD :Not dialysed. Dose as in GFR<31 mL/min

HDF/high flux :Unknown dialysability. Dose as in GFR<31 mL/min

CAV/VVHD :Not dialysed. Dose as in GFR<31 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsAnticoagulants, antiplatelets, fondaparinux, NSAIDs, heparin and dextran – increased risk of bleeding

ADMINISTRATION

Reconstition

With diluent supplied

Route

Rate of Administration

–

Comments

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OTHER INFORMATION

The effect is poorly reversible APTT levels can be reduced by IV DDAVP Available on a named patient basis from Aventis Pharma7% of dose is metabolised by the kidneys

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