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Synthetic analog by recombinant technology of natural hirudin consisting of a polypeptide chain of 65 amino acids.
It is a thrombin inhibitor; it inhibits platelet aggregation and fibrinogen formation.
Indicated for the prevention of thromboembolism in patients with heparin-induced thrombocytopenia and in myocardial infarction and unstable angina.
Subcutaneous administration twice a day or by intravenous infusion for two to ten days.
Probably its high molecular weight and absolute fixation to plasma thrombin explain the null passage to breast milk observed in a mother treated with lepirudin for three months; no bleeding or other problems were seen in the infant (Lindhoff 2000).
Due to its protein nature, it is inactivated in the gastrointestinal tract, not being absorbed (practically nil oral bioavailability), which hinders or prevents the passage into plasma of the infant from ingested breast milk except in the premature and during the immediate neonatal period, during which there may be increased intestinal permeability.
It was withdrawn from the market in 2011 for commercial reasons (EMA 2011).