Lepirudin (rDNA), Injection lep-ih-ROO-din

What are other names for this medicine?

Type of medicine: thrombin inhibitor; anticoagulant

Generic and brand names: lepirudin, injection; Refludan

What is this medicine used for?

This medicine is given by injection (shot) and IV infusion (slow drip into a vein) to prevent or treat blood clots in people with thrombocytopenia (too few platelets in your blood) caused by heparin. It may be used for other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergy to any medicine
• a brain or spinal tumor
• a stroke
• bleeding problems
• endocarditis (infection in the heart)
• high blood pressure
• kidney or liver disease
• ulcers

Also tell your provider if you have recently had surgery or a biopsy.

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

This medicine is given by a healthcare provider while you are in the hospital. The medicine is usually given by an injection (shot), followed by an IV infusion (slow drip into a vein) over several days.

What should I watch out for?

Bleeding is the most common side effect. Your healthcare provider will check for any signs of bleeding. Report any unusual bleeding or bruising (bleeding gum, nosebleed, blood in urine or stools), pain in joints or back, fever, or nausea that does not go away.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you have received this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away: Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report these to your healthcare provider right away): Shortness of breath that gets worse; sudden weakness, numbness, slurred speech, confusion, blurred vision or eye pain; severe headache; unusual bleeding or bruising, blood in the urine, or bloody bowel movements.

Other: Nausea, vomiting, swelling, diarrhea, fever, headache, dizziness, cough, runny nose, mild rash, itching or swelling at injection site.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• aspirin or other salicylates
• medicines that affect blood clotting such as cilostazol (Pletal), clopidogrel (Plavix), dalteparin (Fragmin), dipyridamole (Persantine), enoxaparin (Lovenox), heparin, and warfarin (Coumadin)
• natural remedies such as cat's claw, dong quai, evening primrose oil, feverfew, fish oil, garlic, ginger, ginkgo, ginseng, green tea, hawthorn, horse chestnut, and red clover
• nonsteroidal anti-inflammatory medicines (NSAIDs) such as diclofenac (Voltaren, Cataflam), ibuprofen (Motrin, Motrin IB, Advil), indomethacin (Indocin), ketoprofen, ketorolac (Toradol), nabumetone (Relafen), naproxen (Naprosyn, Anaprox, Aleve, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Keep all medicines out of the reach of children.

Do not share medicines with other people.