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Lepirudin (REFLUDAN) - Renal dosing

Usual Dosing (Adults)

Heparin-induced thrombocytopenia: Bolus dose: 0.4 mg/kg IVP (over 15-20 seconds), followed by continuous infusion at 0.15 mg/kg/hour ( bolus and infusion must be reduced in renal insufficiency). Do not exceed 0.21 mg/kg/hour. Max initial bolus: 44 mg. Max initial infusion rate: 16.5 mg/hour.

Renal Dosing

dialysis [CRCL > 60 ml/min]: No changes.

[45-60 ml/min] or [Scr 1.6-2.0 mg/dL]:
Bolus dose: 0.2 mg/kg IVP (over 15-20 seconds).
Adjust rate to 50% of standard infusion rate: 0.075mg/kg/hour.

[30-44 ml/min] or [ Scr 2.1-3.0 mg/dL]:
Bolus dose: 0.2 mg/kg IVP (over 15-20 seconds).
Adjust rate to 30% of standard infusion rate: 0.045mg/kg/hour.

[15-29 ml/min] or [ Scr 3.1-6.0 mg/dL]:
Bolus dose: 0.2 mg/kg IVP (over 15-20 seconds)
Adjust rate to 15% of standard infusion rate: 0.0225mg/kg/hour.

[<15 ml/min] or [Scr>6.0 mg/dl]:
Avoid or STOP infusion.

Hemodialysis

dialysis Avoid Use.

Reference(s)

National Institutes of Health, U.S. National Library of Medicine, DailyMed Database.
Provides access to the latest drug monographs submitted to the Food and Drug Administration (FDA). Please review the latest applicable package insert for additional information and possible updates.  A local search option of this data can be found here.

Disclaimer

The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical judgment. Neither GlobalRPh Inc. nor any other party involved in the preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material.PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER.   Read the disclaimer
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