Desirudin, Injection

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KEY POINTS

• This medicine is given by injection to prevent blood clots when you have hip replacement surgery. Use it exactly as directed.
• This medicine may cause serious bleeding problems or other unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: thrombin inhibitor; anticoagulant (medicine that reduces the chance of blood clots forming)

Generic and brand names: desirudin, injection; Iprivask

What is this medicine used for?

This medicine is given by injection (shot) to prevent deep vein thrombosis (blood clots) and blood clots in the lungs (pulmonary embolisms) when you have hip replacement surgery.

This medicine may be used to treat other conditions as determined by your healthcare provider.

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

Tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• A stroke or transient ischemic attack (TIA)
• Bleeding problems
• Bacterial endocarditis (heart infection)
• Brain, spinal or eye surgery
• Eye injury or eye problems due to diabetes
• High blood pressure
• Kidney or liver problems
• Stomach or intestinal problems such as ulcerative colitis, Crohn's disease, heartburn, ulcers, or bleeding

Tell your healthcare provider if have recently had, or will be having a spinal or epidural procedure, or if you have any kind of problems with your spine.

Be sure to tell your healthcare provider if you are taking any medicine that may increase the risk of bleeding, such as warfarin (Coumadin), aspirin, or non-steroidal anti-inflammatory drugs (NSAIDs).

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed without your healthcare provider's approval.

How do I use it?

This medicine is given by subcutaneous (under the skin) injection. These shots are usually given by your healthcare provider. They are given for several days or until you are able to get up and walk around. The shots may be given in the abdomen or thigh. Keep all appointments.

Sometimes you or someone at home can give the shots to you. Your healthcare provider will teach you how to use this medicine at home. Be sure you know how and when to have shots and how much medicine to use. Do not stop using this medicine without your healthcare provider's approval. Rotate the injection sites as directed by your healthcare provider. Follow your healthcare provider's instructions carefully. If you are not sure how to use this medicine, ask your healthcare provider or pharmacist for help.

Carefully read and follow the directions that come in the package of medicine for preparing and giving the shots. Wash your hands before using this medicine.

Discard the needles as instructed by your healthcare provider. Use each needle only once. Throw them away after use in rigid puncture-resistant containers with lids or caps, such as heavy plastic bleach bottles with screw caps. Do not throw them directly into garbage cans or dumpsters.

Check with your healthcare provider before using this medicine in children under age 18.

What if I miss a dose?

Do not miss a dose. If you miss a dose, contact your healthcare provider for instructions.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: unusual bruising or bleeding, black or tarry bowel movements, blood in the urine, nosebleeds.

What should I watch out for?

This medicine may increase your risk of serious bleeding problems if you have spinal anesthesia, an epidural, or a spinal tap. Rarely, this bleeding may lead to paralysis. Your risk is greater if you have problems with your spine, have an indwelling epidural catheter, or if you take other medicines that affect blood clotting. Talk with your healthcare provider about this.

Bleeding is the most common side effect. You will need to have blood tests regularly to see how this medicine affects you. Keep all appointments for these tests. Your healthcare provider will watch for side effects and be able to treat emergencies if they happen.

Use a soft brush to brush your teeth. Be careful while shaving, cutting fingernails or toenails, or when using sharp objects.

To avoid bruising, do not rub the skin where the shot is given.

This medicine may make you feel faint or dizzy. Do not drive or operate machinery until you are fully alert.

Do not drink alcohol or take aspirin while receiving this medicine. It may increase the risk of bleeding.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking 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. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives, itching, rash, tightness or pain in your chest, swelling of your lips, tongue or throat, trouble breathing); sudden weakness, numbness, or tingling, especially on one side of your body; sudden or severe headache; sudden trouble with vision, speech, balance, or walking.

Serious (Report these to your healthcare provider right away.): Unusual bruising or bleeding; dark urine or bowel movements; bloody urine; increased menstrual flow or vaginal bleeding; vomiting blood or material that looks like coffee grounds; swelling, numbness, or tingling in fingers, legs, or toes, or any unexplained swelling; severe joint or muscle pain; shortness of breath; back pain; loss of bladder or bowel control; confusion; pain, swelling, or redness in lower legs; chest pain; sudden cough; severe dizziness or fainting; severe tiredness or weakness.

Other: Nausea, vomiting, mild dizziness.

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:

• Alcohol
• Aspirin and other salicylates
• Cancer medicines such as dasatinib (Sprycel), ibritumomab (Zevalin), ibrutinib (Imbruvica), and tositumomab (Bexxar)
• Deferasirox (Exjade, Jadenu)
• Medicines to treat or prevent blood clots such as abciximab (ReoPro), alteplase (Activase), anagrelide (Agrylin), apixaban (Eliquis), cilostazol (Pletal), clopidogrel (Plavix), dabigatran (Pradaxa), dalteparin (Fragmin), dipyridamole (Persantine), enoxaparin (Lovenox), fondaparinux (Arixtra), heparin, prasugrel (Effient), reteplase (Retavase), rivaroxaban (Xarelto), tenecteplase (TNKase), ticagrelor (Brilinta), vorapaxar (Zontivity), and warfarin (Coumadin)
• Medicines to treat pulmonary hypertension such as iloprost (Ventavis) and treprostinil (Remodulin, Tyvaso)
• Natural remedies such as agrimony, alfalfa, anise, arnica, bilberry, black cohosh, bladderwrack, bromelain, cat’s claw, dong quai, evening primrose oil, fenugreek, feverfew, fish oil, garlic, ginger, ginkgo biloba, ginseng, goldenseal, grape seed, green tea, horse chestnut, licorice, nettle, passion flower, pau d'arco, red clover, reishi, SAMe, St. John's wort, sweet clover, turmeric, and willow
• Nonsteroidal anti-inflammatory medicines (NSAIDs) such as celecoxib (Celebrex), diclofenac (Cambia, Voltaren, Zipsor), ibuprofen (Advil, Motrin), indomethacin (Indocin), ketoprofen, ketorolac, nabumetone (Relafen), naproxen (Aleve, Anaprox, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)
• Paroxetine (Brisdelle, Paxil, Pexeva)
• Pentoxifylline
• SSRI antidepressants such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), and sertraline (Zoloft)
• Vitamin E

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.

How should I store this medicine?

Store this medicine in the original container at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light. After mixing the solution for injection, it can be stored for up to 24 hours at room temperature. Any unused medicine should be discarded after 24 hours.

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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.