Lepirudin is a medication that helps to prevent blood clotting, and may be used in instances where patients develop bad reactions to alternatives like heparin. In some cases, heparin doses cause a condition called thrombocytopenia, where blood platelet levels drop significantly. If heparin-induced thrombocytopenia occurs, physicians may turn to medicines like lepirudin instead, or they may use the drug to treat other disorders like acute coronary syndrome. The fact that it is only available for use in intravenous form makes it a less frequently utilized medication.
It is interesting to evaluate the invention of this medicine, which first became publicly available in the late 20th century. Though it is lab engineered, its structure is based on hirudin. Hirudin is derived from a leech species that have been used for medicinal purposes for millennia in numerous cultures. Hirudo medicinalis has elements in its salivary glands that affect thrombin, a special enzyme that directs blood cells to clot. When drugs like lepirudin or hirudin impair thrombin, they slow down clotting time and may reduce formation of dangerous blood clots.
Any drug like lepirudin requires extremely careful monitoring and the medicine is most often administered in hospital settings because it must be intravenously infused. The danger of impairing thrombin is that it can result in excess bleeding. There are many contraindications when it comes to this medicine and it’s usually not used if people have had recent surgery, stroke, bleeding ulcers, any other form of bleeding condition, injuries to the organs or blood vessels, infection in the heart, or impairment of the kidneys. The last recommendation is necessary because the drug clears through the kidneys and may not leave the body as needed if the kidneys aren’t working well; this could cause overdose of the medicine.
Certain medications are almost never given with lepirudin. These include most other anticoagulants like warfarin, Plavix®, and heparin, which could all increase risk of excess bleeding. Occasionally, lepirudin and drugs like aspirin are administered together. Any other medicines that clear through the kidneys may need to be considered carefully.
There is risk for hemorrhage when taking lepirudin and evidence of this could include sudden extreme weakness, vomiting blood, bloody or black stools, extreme fatigue, anemia, or loss of consciousness. Other risks of this medicine include allergic rash, fever, liver dysfunction, greater risk of infection, and in the most extreme scenarios, failure of an organ. Despite these dire potential side effects, which are exception rather than rule, lepirudin has been shown to be about as effective as heparin in treating heart attacks or blood clots. This makes it useful as a heparin alternative, providing medical treatment to those who previously lacked good anticoagulant treatment, due to adverse heparin reactions.