Therapy related coagulopathies

Author: Jeremy Parsons, M.D. (see Authors page)

Revised: 28 April 2016, last major update June 2012

Copyright: (c) 2002-2016,, Inc.

PubMed Search: Hirudin [title]

Cite this page: Hirudin. website. Accessed October 22nd, 2018.
Definition / general
  • Anticoagulant approved by FDA to treat thrombosis in patients with heparin induced thrombocytopenia (does not itself cause this type of syndrome)
  • Derivatives include lepirudin, refludan
  • Recombinant protein, cloned from a leech (Wikipedia), which directly inhibits factor IIa (thrombin)
  • Also has fibrinolytic properties
  • More predictable anticoagulant effect than standard heparin, less need for laboratory monitoring, although close monitoring is still advised with PTT, though this assay has limitations (ecarin clotting time is preferable)
  • Prolongs PT, PTT, thrombin time, ACT, and interferes with most clotting based assays
  • Therapeutic range to treat DVT is PTT that is 1.5 - 2.5 x normal, but more specific assays are also used to monitor, such as ecarin clotting time
  • Half-life ~one hour, may be prolonged if antibodies develop, dramatically prolonged in renal failure
  • No reversal agent
Additional references