Recommended and actual lepirudin doses in patients with renal insufficiency

Saxer, Sarah B.; Smith, Brian S.; Gandhi, Pritesh J.; Tataronis, Gary; Krikorian, Susan A.

doi:10.1093/ajhp/60.24.2588

Cited by 5 publications

(1 citation statement)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients with renal insufficiency have a heightened risk for drug accumulation. 18 A small retrospective study revealed that 58% of patients with renal insufficiency received either bolus or infusion doses of lepirudin that were too high for their estimated creatinine clearance. 18 Whereas it is unknown if supratherapeutic doses of lepirudin contribute to antibody development, clinicians must follow the manufacturer' s dosing recommendations for patients with renal dysfunction to decrease bleeding risk.…”

Section: Considerations For Clinical Practicementioning

confidence: 99%

Severe Anaphylactic Reaction After Repeated Intermittent Exposure to Lepirudin

2007

View full text Add to dashboard Cite

Lepirudin, a recombinant DNA derivative of hirudin, is used to prevent thromboembolic complications caused by heparin-induced thrombocytopenia type II. Anaphylactic and anaphylactoid reactions have been reported with its use in patients both with and without known previous exposure to lepirudin. We describe the case of a 57-year-old woman who received five uneventful courses of lepirudin therapy before having a severe anaphylactic reaction during administration of the intravenous bolus dose that began her sixth course. The patient experienced cardiorespiratory arrest but recovered from the reaction. The decision to administer lepirudin to a patient who has previously received it should be reached with due consideration of the risk:benefit ratio and strategies to manage risk resulting from readministration. Risk factors for an anaphylactic reaction to lepirudin may include use of an initial bolus dose, intravenous rather than subcutaneous administration, length of any single course of therapy beyond 3 days, and repeat administration of lepirudin within 100 days.

show abstract

Section: Considerations For Clinical Practicementioning

confidence: 99%