The direct thrombin inhibitor hirudin

Andreas Greinacher; Theodore E. Warkentin

doi:10.1160/TH07-11-0693

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2008; 99(05): 819-829
DOI: 10.1160/TH07-11-0693

Theme Issue Article

Schattauer GmbH

The direct thrombin inhibitor hirudin

Andreas Greinacher

¹Institut für Immunologie und Transfusionsmedizin, Ernst-Moritz-Arndt Universität Greifswald, Greifswald, Germany

,

Theodore E. Warkentin

²Department of Pathology and Molecular Medicine, and Department of Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada

› Author Affiliations

Abstract

Summary

This review discusses the pharmacology and clinical applications of hirudin, a bivalent direct thrombin inhibitor (DTI). Besides the current major indication for hirudin – anticoagulation of patients with heparin-induced thrombocytopenia (HIT) – the experience with hirudin in other indications, especially acute coronary syndromes, are briefly presented. Hirudins have been formally studied prior to their regulatory approval; however, important information on their side effects and relevant preventative measures only became available later. Therefore, current recommendations and dosing schedules for hirudin differ considerably from the information given in the package inserts. Drawbacks of hirudin and important precautions for avoiding potential adverse effects are discussed in detail in the third part of this review.

Keywords

Thrombin - deep vein thrombosis - hirudin - HIT

Full Text

References

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