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 &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :6963.4
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :No data
  • %Excreted unchanged in urine &nbsp &nbsp : 40–50

  • Volume of distribution (L/kg) &nbsp &nbsp &nbsp :0.25

  • half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :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 &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Not dialysed. Dose as in GFR<31 mL/min

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not dialysed. Dose as in GFR<31 mL/min
  • HDF/high flux &nbsp :Unknown dialysability. Dose as in GFR<31 mL/min
  • CAV/VVHD &nbsp &nbsp &nbsp: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

    SC

    Rate of Administration

    –

    Comments

    –

    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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