Refludan

Refludan Uses, Dosage, Side Effects, Food Interaction and all others data.

Refludan is identical to natural hirudin except for substitution of leucine for isoleucine at the N-terminal end of the molecule and the absence of a sulfate group on the tyrosine at position 63. It is produced via yeast cells. Bayer ceased the production of lepirudin (Refludan) effective May 31, 2012.

Refludan is used to break up clots and to reduce thrombocytopenia. It binds to thrombin and prevents thrombus or clot formation. It is a highly potent, selective, and essentially irreversible inhibitor of thrombin and clot-bond thrombin. Refludan requires no cofactor for its anticoagulant action. Refludan is a recombinant form of hirudin, an endogenous anticoagulant found in medicinal leeches.

Table Of contents

• Refludan
• Uses
• Dosage
• Side Effect
• Precautions
• Interactions
• Uses during Pregnancy
• Uses during Breastfeeding
• Accute Overdose
• Food Interaction
• Half Life
• Volume of Distribution
• Clearance
• Interaction With other Medicine
• Contradiction
• Storage

Trade Name	Refludan
Availability	Discontinued
Generic	Lepirudin
Lepirudin Other Names	Hirudin variant-1, Lepirudin, Lepirudin recombinant
Related Drugs	oprelvekin, Neumega, Refludan
Type	Injection
Formula	C287H440N80O110S6
Weight	6963.425 Da
Groups	Approved
Therapeutic Class
Manufacturer
Available Country	United States, Italy, Netherlands, Portugal
Last Updated:	September 19, 2023 at 7:00 am

Uses

Refludan is a protein-based direct thrombin inhibitor used to reverse and prevent thrombus formation in heparin-induced thrombocytopenia.

For the treatment of heparin-induced thrombocytopenia

How Refludan works

Refludan forms a stable non-covalent complex with alpha-thrombin, thereby abolishing its ability to cleave fibrinogen and initiate the clotting cascade. The inhibition of thrombin prevents the blood clotting cascade.

Toxicity

In case of overdose (eg, suggested by excessively high aPTT values) the risk of bleeding is increased.

Food Interaction

• Avoid herbs and supplements with anticoagulant/antiplatelet activity. Examples include garlic, ginger, bilberry, danshen, piracetam, and ginkgo biloba.

Refludan Hypertension interaction

[Moderate] Anticoagulants should be used with extreme caution in patients at increased risk for hemorrhage, including those patients with severe hypertension.

Refludan Drug Interaction

Major: bivalirudin, bivalirudin, warfarin, warfarinUnknown: amoxicillin / clavulanate, amoxicillin / clavulanate, glucose, glucose, indium pentetate in-111, indium pentetate in-111, acetaminophen, acetaminophen, tiotropium, tiotropium

Refludan Disease Interaction

Major: hemophilia, liver disease, peptic ulcer disease, retinopathy, subacute bacterial endocarditisModerate: hypertension, kidney disease

Volume of Distribution

• 12.2 L [Healthy young subjects (n = 18, age 18-60 years)]
• 18.7 L [Healthy elderly subjects (n = 10, age 65-80 years)]
• 18 L [Renally impaired patients (n = 16, creatinine clearance below 80 mL/min)]
• 32.1 L [HIT patients (n = 73)]

Elimination Route

Bioavailability is 100% following injection.

Half Life

Approximately 1.3 hours

Clearance

• 164 ml/min [Healthy 18-60 yrs]
• 139 ml/min [Healthy 65-80 yrs]
• 61 ml/min [renal impaired]
• 114 ml/min [HIT (Heparin-induced thrombocytopenia)]

Elimination Route

Refludan is thought to be metabolized by release of amino acids via catabolic hydrolysis of the parent drug. About 48% of the administration dose is excreted in the urine which consists of unchanged drug (35%) and other fragments of the parent drug.

Innovators Monograph

You find simplified version here Refludan