Desirudin (subcutaneous)

Desirudin is used to prevent blood clots that can cause serious health problems from developing in patients with deep venous thrombosis.

Overview

Desirudin is used to prevent blood clots from developing in patients with deep venous thrombosis. This condition is harmful to the body and can potentially cause serious health implications. In some cases, blood clots can dislodge from the blood vessels of the legs and cause a blockage in the lungs. When this occurs, the very serious medical condition of pulmonary embolism occurs in the patient. Desirudin helps to prevent this from occurring.

Desirudin is also used following hip replacement treatments. Following this treatment, the patient will be unable to move around and blood clots have an increased likelihood of occurring. The formation of blood clots is likely at this time, so Desirudin is given to help prevent this.

This medication is available only with a doctor's prescription in the form of Iprivask. It is provided as a powder to be reconstituted into a solution for injection beneath the skin of the patient.

Condition treated

  • Deep venous thrombosis
  • Blood clots
  • Hip surgery

Type Of Medicine

  • Direct thrombin inhibitors
  • Blood-thinner

Side Effects

In addition to the required effects of preventing the development of blood clots in the patient, Desirudin can also have farther-reaching side effects. In some cases, side effects may be mild, but in others, they may require that medical attention is given. While not all may occur, patients should contact their doctor immediately if they notice any of the following side effects of treatment:

Occurring more commonly:

  • Bleeding of the gums
  • Visible collection of blood beneath the skin
  • Coughing that produces blood
  • Dark bruising appearing on the skin
  • Difficulty in breathing
  • Difficulty in swallowing
  • Dizziness
  • Headaches
  • Increased flow of menstrual or vaginal bleeding
  • Itching
  • Pain
  • Redness
  • Swelling
  • Nosebleeds
  • Paralysis
  • Difficulty stopping bleeding from cuts
  • Red stools
  • Black stools with a tarry appearance
  • Red urine
  • Dark brown urine
  • Shortness of breath without exertion

Occurring less commonly:

  • Changed skin color of foot or leg
  • Pain, swelling or tenderness of the foot or leg
  • Coughing
  • Increased heartbeat
  • Hives
  • Paleness of the skin
  • Puffy or swollen around the eyes, face, lips or tongue
  • Skin rashes
  • Tightness across the chest
  • Troubled breathing when exerting oneself
  • Unusual bleeding
  • Unusual bruising
  • Unusual tiredness
  • Unusual weakness
  • Wheezing
  • Secretions from wounds

Occurring only rarely:

  • Blood visible in the urine
  • Blurring of vision
  • Confusion or disorientation
  • Dizziness when rising quickly from a lying or sitting position
  • Feverishness
  • Severe headaches
  • Sudden headaches
  • Sudden loss of coordination
  • Slurring of speech beginning suddenly
  • Sweating when cool
  • Swelling, pain, tenderness, warmth, skin discoloration and prominence of superficial veins in the affected area
  • Trouble with wound healing
  • Vomiting up blood or materials that appear like coffee grounds

Other side effects may occur that do not usually require the patient to seek medical attention. These side effects are usually mild and usually abate over time as your body adjusts to the treatment you are taking. In some cases, these side effects may become bothersome or be ongoing and your healthcare professional may be able to help you to alleviate these symptoms. The following side effects would not normally, however, necessitate a trip to a medical professional:

  • Nausea
  • Vomiting

Other side effects that have not been listed herein may also occur. If you experience other side effects not listed, you should contact your doctor for advice. If you believe that your immediate health is at risk, however, then you should contact the emergency services.

Dosage

This medication should be administered by a trained healthcare professional only. The treatment will be administered as an injection directly under the skin of the patient in the abdomen or thighs.

In some cases of prolonged use, your doctor may allow you to use this treatment at home. In this case, you will be taught how to administer the injection to yourself. When self-administering it is vital that you follow the instructions given very closely and consult your doctor if you have any concerns at all about the use of the treatment.

This medication should be administered to a different part of the body each time to reduce the risk of the development of skin conditions. You should keep track of where each shot was administered so you can rotate between them effectively. Please note that repeated injections into the same site will cause skin irritations that must be avoided.

You should only ever use the prescribed brand of this medication. Different brands of Desirudin can work differently and should not be interchanged.

If this medication has changed in appearance at all, you should not use it. Nor should you use it if you can see particles visibly suspended in the treatment.

After administration, you must follow safe disposal practices for the medication and needles. The used needle should be put into a container that will not allow it to poke through before disposal and should be kept well out of reach of both children and pets.

The dose administered of this medication will be different for each patient, depending on a range of factors. These include the condition being treated, the severity of the condition, the age of the patient, other medical conditions that the patient has and other factors. You should only ever take the dose as prescribed by your doctor and should not make any changes to the dose you are taking unless ordered to by your doctor. The following dosing information is a guideline only:

For use by subcutaneous injection in the treatment of deep venous thrombosis and following hip replacement treatment:

  • Adults' 15mg injected under the skin every 12 hours
  • Adults with poorly performing kidneys' 5.1mg injected under the skin every 12 hours
  • Children'“ Use of this treatment in children must be determined by the prescribing doctor.

This medication needs to be taken on a schedule to control the clotting of blood in your body and reduce the risk of serious medical conditions developing. If you miss a dose of this treatment, you should contact your doctor for advice.

Interactions

Before taking any medication it is important that you inform your doctor of all other treatments you are receiving. This includes medications that have been prescribed, purchased over the counter or received in any other manner. It also includes vitamin supplements and herbal remedies. The use of other medications alongside Desirudin can cause serious unwanted side effects. In some cases, medications should not be used at all with Desirudin and in others, the use of both may increase the risk of side effects occurring or make side effects more severe. Some drugs can also stop one another from working.

Patients taking Desirudin should not also take the following medication. Use together is not recommended and your doctor may choose to prescribe a different medication:

  • Defibrotide

The use of Desirudin with the following medications would not normally be advised. In some cases, your doctor may prescribe both, but the frequency of use or doses may be adjusted for one or both treatments:

  • Vortioxetine
  • Vorapaxar
  • Vilazodone
  • Venlafaxine
  • Valdecoxib
  • Urokinase
  • Treprostinil
  • Tolmetin
  • Tolfenamic Acid
  • Tirofiban
  • Ticlopidine
  • Tiaprofenic Acid
  • Tenoxicam
  • Tenecteplase
  • Tan-Shen
  • Sulindac
  • Sulfinpyrazone
  • Streptokinase
  • St John's Wort
  • Sertraline
  • Selexipag
  • Rofecoxib
  • Rivaroxaban
  • Reteplase, Recombinant
  • Proquazone
  • Propyphenazone
  • Proglumetacin
  • Prasugrel
  • Pranoprofen
  • Piroxicam
  • Piracetam
  • Piketoprofen
  • Phenylbutazone
  • Pentosan Polysulfate Sodium
  • Paroxetine
  • Parecoxib
  • Papaya
  • Oxyphenbutazone
  • Oxaprozin
  • Orlistat
  • Nintedanib
  • Nimesulide Beta Cyclodextrin
  • Nimesulide
  • Niflumic Acid
  • Nepafenac
  • Naproxen
  • Nabumetone
  • Morniflumate
  • Milnacipran
  • Meloxicam
  • Mefenamic Acid
  • Meclofenamate
  • Lumiracoxib
  • Loxoprofen
  • Lornoxicam
  • Levomilnacipran
  • Ketorolac
  • Ketoprofen
  • Indomethacin
  • Iloprost
  • Ibuprofen
  • Ginkgo
  • Garlic
  • Fluvoxamine
  • Flurbiprofen
  • Fluoxetine
  • Flufenamic Acid
  • Floctafenine
  • Feprazone
  • Fepradinol
  • Fenoprofen
  • Fenofibric Acid
  • Fenofibrate
  • Felbinac
  • Etoricoxib
  • Etofenamate
  • Etodolac
  • Escitalopram
  • Eptifibatide
  • Epoprostenol
  • Edoxaban
  • Droxicam
  • Dipyrone
  • Dipyridamole
  • Diflunisal
  • Diclofenac
  • Dexketoprofen
  • Dexibuprofen
  • Desvenlafaxine
  • Dabigatran Etexilate
  • Collagenase, Clostridium histolyticum
  • Clopidogrel
  • Clonixin
  • Citalopram
  • Cilostazol
  • Choline Salicylate
  • Chamomile
  • Celecoxib
  • Cangrelor
  • Bufexamac
  • Bromfenac
  • Aspirin
  • Apixaban
  • Anistreplase
  • Anagrelide
  • Amtolmetin Guacil
  • Alteplase, Recombinant
  • Alipogene Tiparvovec
  • Acemetacin
  • Aceclofenac
  • Abciximab

Using the following medications alongside Desirudin can increase the risk of certain side effects occurring and can make side effects more severe too. Your doctor may still prescribe both treatments, but they may wish to adjust the dose or frequency of use of one or more of the treatments:

  • Vitamin A
  • Ginger
  • Dong Quai
  • Curcumin
  • Coenzyme Q10
  • Chondroitin

Drug interactions may occur that have not been listed herein. These medications have been selected for severity and other medications may also interact with Desirudin. You should inform your doctor of all medications that you are taking before beginning this treatment.

Medications can also interact with foods, alcohol, tobacco and other substances. In certain cases these may need to be avoided during treatment. In the case of Desirudin patients should avoid consumption of avocado before beginning treatment as this may interact in the body with unwanted effects.

Medical problems from which the patient suffers can also affect the use of this treatment. You should inform your doctor of all ailments both past and present from which you have suffered before beginning use of Desirudin. This is particularly important in the following cases:

Patients with these conditions should not be treated with Desirudin:

  • Blood clotting disorders
  • Active major bleeding

Caution should be used when treating patients with the following conditions:

  • Blood disease
  • Bleeding problems
  • Catheter insertion in spine
  • Eye problems, as a result of diabetes
  • Heart infections
  • Hypertension
  • Liver disease
  • Recent major surgery
  • History of stomach ulcerations
  • History of stroke
  • History of major surgery to eye, brain or spine.

Effects and side effects of Desirudin may be intensified in patients with the following due to the slower removal of medication from the body in patients with the following condition:

  • Kidney disease

Other medical conditions may also prohibit or impact the use of this medication. Ensure that you inform your doctor of your full medical history before use.

Warnings

Before beginning the use of this treatment patients should familiarize themselves with the potential risks of use in relation to the benefits of use. The decision to take this treatment should be made by the patient and doctor having considered all relevant factors. Ensure that you have considered the following before beginning use:

Allergies'Inform your doctor if you have ever reacted strangely or badly to any medications in the past. Ensure that your doctor is also aware of any other allergies from which you suffer before beginning treatment.

Pediatric' The safety and efficiency of use in children has not been established. You should discuss this with your doctor, although the conditions treated by this medication are usually occurring in adults only.

Geriatric' There are no known limitations to the use of Desirudin in elderly patients. Caution will need to be taken because of an increased likelihood of there being other age-related medical conditions that may affect the use of this treatment. Be aware of kidney, heart and blood vessel conditions that may inhibit use.

Pregnancy 'Risks from the use during pregnancy cannot be ruled out. You should discuss this with your doctor if you are pregnant or may become pregnant during the use of this treatment. If you believe you have become pregnant during use then you should contact your doctor immediately.

Breastfeeding'The risks of breastfeeding during the use of this treatment are unknown. You should discuss this with your doctor and weigh the benefits of breastfeeding against the risks of doing so.

During use of this treatment, your doctor will need to carry out regular check-ups on you. Ensure that you attend all appointments so that the correct effect of the medication can be observed.

Anaphylaxis can occur from the use of this treatment. This severe allergic reaction can be life-threatening and needs to be treated immediately. The following symptoms of anaphylaxis should trigger contacting the emergency services:

  • Swelling of the tongue
  • Swelling of the throat
  • Swelling of the face
  • Rash
  • Itching
  • Difficulty in breathing
  • Chest pains

Desirudin may cause you to bruise and bleed more easily while you are using it. You should avoid sports and activities where you may be bruised or injured. You should also avoid the use of sharp implements near your body and should avoid picking your nose.

Talk to your doctor about alternative ways in which you can clean your teeth during use of this treatment. Brushing, picking, and flossing may cause bleeding of the gums and may need to be avoided.

You should inform any doctors or dentists who will be administering treatment to you that you are using Desirudin before you have any other tests or treatments carried out. This medication may need to be halted before surgeries can be carried out.

No other medications should be taken or discontinued without first discussing this with your doctor. This includes vitamins and herbal remedies.

There is a risk of bleeding and bruising from this treatment that is intensified by the following conditions:

  • Catheter in your back
  • Kidney problems
  • Severe kidney problems

If you experience any of the following symptoms of bleeding problems then you should inform your doctor immediately:

  • Black stools with a tarry appearance
  • Bleeding gums
  • Blood in urine
  • Blood in stools
  • Red spots on skin

Storage

This medication and all administration paraphernalia should be stored well out of the reach of children at all times.

You should not keep outdated medication or unwanted medication. Discuss disposal of unwanted medication and use medication with your doctor.

Unopened, prefilled vials or syringes should be stored at room temperature. Keep them away from heat, moisture and out of direct light.

Mixed solution can be stored and used for up to 24 hours at room temperature. After this period it should be discarded if unused.

Needles should be placed in a hard, sealed container that cannot be pierced by needles before they are disposed of. Used needles should be safely disposed of and should be kept well out of reach of children and pets before use.

Summary

Desirudin is used to prevent the clotting of blood in the patient. Doing so prevents the blood from clotting into the veins in the leg and reduces the risk of these clots dislodging and causing pulmonary embolism.

Desirudin is used in patients who suffer from deep venous thrombosis and in patients who have recently received hip replacement surgery.

This treatment thins the blood and will expose the patient to greater risks of bruising and bleeding on a daily basis. It may also expose the patient to further medical complications.

Desirudin is administered as an injection under the skin. This is usually carried out by a healthcare professional but it may also be self-administered in certain cases.