Lepirudin

Lepirudin

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Lepirudin directly inhibits thrombin, and is used in the treatment of heparin-induced thrombocytopenia (HIT). It is renally excreted. Monitor the APTT ratio [Note 1] 4 hours before commencing, and if the ratio is equal to or greater than 2.5 do not start lepirudin. Use the APTT ratio and the creatinine clearance to adjust the maintenance dose. Use of lepirudin should be avoided if the creatinine clearance is less than 15 mL/minute.

Note 1: The APTT ratio is defined as the patient's activated partial tromboplastin time (APTT) divided by the mid-point of the laboratory reference range.