Abciximab
Severe
Database
Clinical effect not specified
Source: DDInter
Drug reference
desirudin
Direct thrombin inhibitor (recombinant hirudin) · Anticoagulant
START
15 mg SC twice daily peri-operatively (hip arthroplasty)
TYPICAL MAX
15 mg SC twice daily for 9–12 days
STOP IF
Major bleeding or anaphylaxis
WATCH
aPTT, renal function, bleeding signs; neuraxial-block timing
CDSCO approvedATC B01AE01
KDIGO 2024 + manufacturer label
- ONSET
- 15min · SC onset
- PEAK
- 2h · aPTT peak
- t½
- 2h · t½
- DURATION
- 12h · BID dose
EXCRETION
Renal — clearance reduced in impairment
route + CYP
INTERACTIONS
12 major
SEVERE in our sources
PREGNANCY
Use only if clearly needed; limited data.
FDA category + note
Top interactionssee all 12 →
- AbciximabSevereDatabaseDDInter
- AcalabrutinibSevereDatabaseDDInter
- AlteplaseSevereDatabaseDDInter
- AnagrelideSevereDatabaseDDInter
Mechanism
Recombinant hirudin variant that binds directly and irreversibly to both the catalytic and exosite-1 of thrombin, inhibiting fibrin formation and thrombin-induced platelet activation — without requiring antithrombin.
Indications
Prophylaxis of deep-vein thrombosis after elective hip replacement
Dosing
- Adult
- 15 mg SC twice daily, starting 5–15 min before surgery (after induction) and continuing for 9–12 days.
- Pediatric
- Not established.
- Renal adjustment
- CrCl 31–60: monitor; consider reduced dose. CrCl <30: contraindicated.
- Hepatic adjustment
- Caution in significant hepatic impairment (limited data).
- Geriatric
- Higher bleeding risk; assess renal function.
- Max dose
- 15 mg SC twice daily
Pharmacokinetics
Onset
Anticoagulation within minutes of SC
Peak effect
~1–3 h (aPTT peak)
Duration
~12 h (twice-daily)
Half-life
~2 h (much longer in renal failure)
Bioavailability
SC well absorbed
Protein binding
Not applicable (binds thrombin)
Metabolism
Proteolytic catabolism
Excretion
Renal (clearance markedly reduced in impairment)
Contraindications
- Active bleeding
- Severe uncontrolled hypertension
- Recent intracranial/spinal/eye surgery
- Hypersensitivity to hirudins
- Severe renal impairment (CrCl <30 — accumulation)
Side effects
Common
Bleeding/haematomaInjection-site reactionsAnaemiaWound secretion
Serious
- Major bleeding
- Spinal/epidural haematoma (with neuraxial anaesthesia)
- Severe hypersensitivity/anaphylaxis
- Antibody formation (chronic hirudin re-exposure)
Pregnancy & lactation
Pregnancy
Use only if clearly needed; limited data.
Lactation
Limited data; caution.
Drug interactions
Acalabrutinib
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Alteplase
Severe
Database
Clinical effect not specified
Source: DDInter
Anagrelide
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Anisindione
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Anistreplase
Severe
Database
Clinical effect not specified
Source: DDInter
Antithrombin Iii Human
Severe
Database
Clinical effect not specified
Source: DDInter
Apixaban
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Ardeparin
Severe
Database
Clinical effect not specified
Source: DDInter
Argatroban
Severe
Database
Clinical effect not specified
Source: DDInter
Aspirin
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Avapritinib
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Related guidelines
GI bleeding on antiplatelet or anticoagulant therapy
CSI · Cardiology · 2020
Venous thromboembolism prophylaxis
ASH · Haematology · 2018
Anticoagulant management for dental procedures
ADA_DENTAL · Dentistry · 2015
Heart failure in diabetes
RSSDI · Cardiology · 2023
Infective endocarditis prevention
NICE · Cardiology / Dentistry · 2008
Ask House about desirudin
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: Goodman & Gilman 14e·Verified: 2026-05-20 · House clinical team·Cockpit curated: 2026-05-20