Refludan
Generic Name: Lepirudin
Product Name: Refludan
Indication
Refludan (lepirudin) is used to treat a condition called acute heparin-induced thrombocytopaenia (HIT) type II. Rarely, some patients treated with the anti-clotting drug heparin develop a complication known as acute heparin induced thrombocytopaenia (HIT). These patients have very low levels of platelets in their blood, and can also develop problems with excess clotting. Lepirudin can be used to raise platelet levels in these patients, and also to prevent excess clotting and the complications which may result from this, including pulmonary embolism, stroke or heart attack.
Action
Refludan (lepirudin) works by binding to and stopping the action of a molecule in the blood called ‘thrombin’. Thrombin is factor which circulates in the blood and helps to form blood clots at sites of injury. By inhibiting thrombin, lepirudin prevents the excess clotting which may be associated with acute heparin-induced thrombocytopaenia (HIT) type II.
Dose advice
Refludan (lepirudin) must be given as an intravenous infusion (through a drip).Initially, the dose of lepirudin you require will be calculated based on your body weight. Approximately four hours after lepirudin therapy has been started, a blood sample will be taken to measure your body’s response to the drug. The dose of lepirudin you are receiving may then be adjusted until an appropriate response is produced.
Schedule
S4
Common side effects
Common side effects of lepirudin therapy (occurring in between 1-10% of patients) include:
- Bleeding: particularly from puncture sites or wounds;
- Abnormal liver function;
- Respiratory allergic reactions, such as cough, shortness of breath, stridor (upper airway obstruction) or bronchospasm (abnormal constriction of the airways).
Uncommon side effects
Rarely, lepirudin may cause severe bleeding. This includes intracerebral bleeds (bleeding into the brain) which may be fatal. Intracranial bleeding occurs in approximately 2 per 1000 patients.Other uncommon side effects include allergic skin reactions and other severe allergic reactions, including anaphylactic shock.
References
- AMH Pty Ltd. Lepirudin. Australian Medicines Handbook: July, 2006.
- MIMS Australia Pty Ltd. Lepirudin. MIMS Online 2003. Available from: http://www.mims.com.au
For further information talk to your doctor.
Dates
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