. . "Lepirudin"@en . . . . . . "Lepirudin is identical to natural hirudin except for substitution of leucine for isoleucine at the N-terminal end of the molecule and the absence of a sulfate group on the tyrosine at position 63. It is produced via yeast cells. Bayer ceased the production of lepirudin (Refludan) effective May 31, 2012."@en . "120993-53-5"@en . . "For the treatment of heparin-induced thrombocytopenia"@en . . "Hirudin variant-1"@en . "Bioavailability is 100% following injection."@en . . . "* 164 ml/min [Healthy 18-60 yrs] * 139 ml/min [Healthy 65-80 yrs] * 61 ml/min [renal impaired] * 114 ml/min [HIT (Heparin-induced thrombocytopenia)]"@en . . . . . . . . . . "In case of overdose (eg, suggested by excessively high aPTT values) the risk of bleeding is increased."@en . "Lepirudin is thought to be metabolized by release of amino acids via catabolic hydrolysis of the parent drug. About 48% of the administration dose is excreted in the urine which consists of unchanged drug (35%) and other fragments of the parent drug."@en . "# Smythe MA, Stephens JL, Koerber JM, Mattson JC: A comparison of lepirudin and argatroban outcomes. Clin Appl Thromb Hemost. 2005 Oct;11(4):371-4. \"Pubmed\":http://www.ncbi.nlm.nih.gov/pubmed/16244762 # Tardy B, Lecompte T, Boelhen F, Tardy-Poncet B, Elalamy I, Morange P, Gruel Y, Wolf M, Francois D, Racadot E, Camarasa P, Blouch MT, Nguyen F, Doubine S, Dutrillaux F, Alhenc-Gelas M, Martin-Toutain I, Bauters A, Ffrench P, de Maistre E, Grunebaum L, Mouton C, Huisse MG, Gouault-Heilmann M, Lucke V: Predictive factors for thrombosis and major bleeding in an observational study in 181 patients with heparin-induced thrombocytopenia treated with lepirudin. Blood. 2006 Sep 1;108(5):1492-6. Epub 2006 May 11. \"Pubmed\":http://www.ncbi.nlm.nih.gov/pubmed/16690967 # Lubenow N, Eichler P, Lietz T, Greinacher A: Lepirudin in patients with heparin-induced thrombocytopenia - results of the third prospective study (HAT-3) and a combined analysis of HAT-1, HAT-2, and HAT-3. J Thromb Haemost. 2005 Nov;3(11):2428-36. \"Pubmed\":http://www.ncbi.nlm.nih.gov/pubmed/16241940 # Askari AT, Lincoff AM: Antithrombotic Drug Therapy in Cardiovascular Disease. 2009 Oct; pp. 440\u2013. ISBN 9781603272346. \"Google books\":http://books.google.com/books?id=iadLoXoQkWEC&pg=PA440. "@en . "Humans and other mammals"@en . . . "* 12.2 L [Healthy young subjects (n = 18, age 18-60 years)] * 18.7 L [Healthy elderly subjects (n = 10, age 65-80 years)] * 18 L [Renally impaired patients (n = 16, creatinine clearance below 80 mL/min)] * 32.1 L [HIT patients (n = 73)]"@en . . . " "@en . "Lepirudin forms a stable non-covalent complex with alpha-thrombin, thereby abolishing its ability to cleave fibrinogen and initiate the clotting cascade. The inhibition of thrombin prevents the blood clotting cascade. "@en . "approved"@en . "Approximately 1.3 hours"@en . .