Refludan

Lepirudin is a type of "blood thinner" used to prevent harmful blood clots. It is usually used in patients who have had a reaction to other "blood thinners" such as heparin (e.g., heparin-induced thrombocytopenia-HIT). Lepirudin works by blocking a certain natural substance (thrombin) that the body uses to form blood clots. Blood clots can stop blood flow to the heart, brain, and limbs, causing a heart attack, stroke, or gangrene.

If your dose is stopped or interrupted, contact the doctor immediately to establish a new dosing schedule/rate.

This medication is given by a health care professional by injection into a vein. The first dose is injected over 15 to 20 seconds (bolus dose). Then treatment is continued by giving the drug more slowly (continuous infusion). The dosage is based on your weight, medical condition, and response to treatment.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval. Some products that may interact with this drug include: other "blood thinners" (e.g., warfarin), NSAIDs (e.g., ibuprofen, naproxen), anti-platelet drugs (e.g., dipyridamole, ticlopidine), tipranavir. Check all prescription and nonprescription medicine labels carefully since many contain pain relievers/fever reducers (NSAIDs such as ibuprofen, naproxen, or aspirin) that are similar to this drug. Lepirudin is often used with other "blood thinners" such as warfarin, aspirin, and clopidogrel. Ask your doctor or pharmacist which medicines you need to take after leaving the hospital. Low-dose aspirin should be continued if prescribed by your doctor for heart attack or stroke prevention (usually at dosages of 81-325 milligrams a day). Consult your doctor or pharmacist for more details.

Laboratory and/or medical tests (e.g., bleeding times, complete blood count) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US National Poison Hotline at 1-800-222-1222. Canada residents can call a provincial poison control center.

Before using lepirudin, tell your doctor or pharmacist if you are allergic to it; or to other hirudins (e.g., bivalirudin) or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: current bleeding. Before using this medication, tell your doctor or pharmacist your medical history, especially of: recent major surgery/injury/other bleeding, stomach/intestinal problems (e.g., peptic ulcer, inflammatory bowel disease), heart infection (bacterial endocarditis), bleeding problems (e.g., anemia, coagulopathy, thrombocytopenia), kidney disease, liver disease, stroke, very high uncontrolled blood pressure, tumor/blood vessel problem in the brain (e.g., aneurysm, AV malformation). During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor. It is unknown if this drug passes into breast milk but is unlikely to have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

Not applicable. This medication is given in a hospital and will not be stored at home.

Minor bleeding/irritation at the injection site may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Serious bleeding is the most common serious side effect. Tell your doctor immediately if any of these signs of serious bleeding occur: easy bleeding/bruising, dizziness/fainting, bleeding/bruising/swelling/oozing from injection site/wounds, uncontrolled nosebleed, fast/irregular heartbeat, pale/gray/bluish skin, pink/red urine, bloody/black/tarry stool, coughing up blood, vomit that looks like coffee grounds. Get medical help right away if any of these signs of very serious bleeding occur: chest pain, vision problems, confusion, slurred speech, weakness on one side of the body. A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.