Desirudin

Identification

Generic Name
Desirudin
DrugBank Accession Number
DB11095
Background

Desirudin is a direct inhibitor of human thrombin. It has a protein structure that is similar to that of hirudin, the naturally occurring anticoagulant present in the peripharyngeal glands in the medicinal leech, Hirudo medicinalis. Hirudin is a single polypeptide chain of 65 amino acids residues and contains three disulfide bridges. Desirudin has a chemical formula of C287H440N80O110S6 with a molecular weight of 6963.52.

It is mainly indicated for the prevention of deep vein thrombosis in hip replacement surgery patients. Common side effects include: Bleeding gums, collection of blood under the skin, coughing up blood, deep, dark purple bruise and difficulty with breathing or swallowing.

Type
Biotech
Groups
Approved
Biologic Classification
Protein Based Therapies
Other protein based therapies
Protein Chemical Formula
C287H440N80O110S6
Protein Average Weight
Not Available
Sequences
Not Available
Synonyms
  • 63-Desulfohirudin
  • 63-Desulfohirudin (Hirudo Medicinalis Isoform HV1)
  • 63-Desulfohirudin (recombinant)
  • Desirudin
  • Desirudin recombinant
  • Desirudina
  • Hirudin desirudin
External IDs
  • CGP-39393

Pharmacology

Indication

Indicated as prophylaxis of deep vein thrombosis for patients undergoing hip replacement surgery.

Pharmacology
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Associated Conditions
Contraindications & Blackbox Warnings
Contraindications
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Pharmacodynamics

Desirudin results in dose-dependent prolongation of the activated partial thromboplastin time (aPTT).

Mechanism of action

Desirudin is a direct, highly selective thrombin inhibitor. Reversibly binds to the active thrombin site of free and clot-associated thrombin. Inhibits fibrin formation, activation of coagulation factors V, VII, and XIII, and thrombin-induced platelet aggregation resulting in a dose-dependent prolongation of the activated partial thromboplastin time (aPTT).

Absorption

Absorption is complete after subcutaneous administration. Time to peak in plasma is 1 to 3 hours.

Volume of distribution

0.25 L/kg.

Protein binding

Desirudin binds specifically and directly to thrombin, forming an extremely tight, non-covalent complex with an inhibitionconstant of approximately 2.6 x 10-13 M. Thus, free or protein bound desirudin immediately binds circulating thrombin.

Metabolism

Human and animal data suggest that desirudin is primarily eliminated and metabolized by the kidney. The total urinary excretion of unchanged desirudin amounts to 40 to 50% of the administered dose. Metabolites lacking one or two C-terminal amino acids constitute a minor proportion of the material recovered from urine (< 7%). There is no evidence for the presence of other metabolites. This indicates that desirudin is metabolized by stepwise degradation from the C-terminus probably catalyzed by carboxypeptidase(s) such as carboxypeptidase A.

Route of elimination

Urine (40% to 50% as unchanged drug).

Half-life

~2 hours.

Clearance

1.5 to 2.7 mL/min/kg.

Adverse Effects
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Toxicity

No data available.

Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
DrugInteraction
AbciximabThe risk or severity of bleeding can be increased when Abciximab is combined with Desirudin.
AceclofenacThe risk or severity of bleeding and hemorrhage can be increased when Aceclofenac is combined with Desirudin.
AcemetacinThe risk or severity of bleeding and hemorrhage can be increased when Acemetacin is combined with Desirudin.
AcenocoumarolThe risk or severity of bleeding can be increased when Acenocoumarol is combined with Desirudin.
Acetylsalicylic acidAcetylsalicylic acid may increase the anticoagulant activities of Desirudin.
Albutrepenonacog alfaThe therapeutic efficacy of Albutrepenonacog alfa can be decreased when used in combination with Desirudin.
AlclofenacThe risk or severity of bleeding and hemorrhage can be increased when Alclofenac is combined with Desirudin.
AldesleukinThe risk or severity of bleeding can be increased when Desirudin is combined with Aldesleukin.
AlemtuzumabThe risk or severity of bleeding can be increased when Desirudin is combined with Alemtuzumab.
AlteplaseThe risk or severity of bleeding can be increased when Desirudin is combined with Alteplase.
Interactions
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Food Interactions
  • Avoid herbs and supplements with anticoagulant/antiplatelet activity. Examples include garlic, ginger, bilberry, danshen, piracetam, and ginkgo biloba.

Products

Products
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Brand Name Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
IprivaskKit30 mg/1mLSubcutaneousCANYON PHARMACEUTICALS, INC2010-08-302014-05-09US flag
IprivaskKit30 mg/1mLSubcutaneousValeant Pharmaceuticals North America LLC2013-12-312018-07-31US flag
IprivaskInjection, powder, lyophilized, for solution15 mg/100mgSubcutaneousCanyon Pharmaceuticals, Inc.2010-06-102010-11-01US flag
IprivaskKit30 mg/1mLSubcutaneousMarathon Pharmaceuticals2013-12-312016-08-31US flag

Categories

ATC Codes
B01AE01 — Desirudin
Drug Categories
Chemical TaxonomyProvided by Classyfire
Description
Not Available
Kingdom
Organic Compounds
Super Class
Organic Acids
Class
Carboxylic Acids and Derivatives
Sub Class
Amino Acids, Peptides, and Analogues
Direct Parent
Peptides
Alternative Parents
Not Available
Substituents
Not Available
Molecular Framework
Not Available
External Descriptors
Not Available
Affected organisms
Not Available

Chemical Identifiers

UNII
U0JZ726775
CAS number
120993-53-5

References

General References
  1. Monograph [Link]
  2. FDA label [Link]
PubChem Substance
347911114
RxNav
114934
Wikipedia
Hirudin

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
4CompletedTreatmentThrombotic events1
4TerminatedPreventionSuspected Heparin-Induced Thrombocytopenia1
2, 3CompletedPreventionDeep Vein Thrombosis1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage Forms
FormRouteStrength
Injection, powder, lyophilized, for solutionSubcutaneous15 mg/100mg
KitSubcutaneous30 mg/1mL
Prices
Not Available
Patents
Not Available

Properties

State
Not Available
Experimental Properties
Not Available

Enzymes

Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
General Function
Zinc ion binding
Specific Function
Carboxypeptidase that catalyzes the release of a C-terminal amino acid, but has little or no action with -Asp, -Glu, -Arg, -Lys or -Pro.
Gene Name
CPA1
Uniprot ID
P15085
Uniprot Name
Carboxypeptidase A1
Molecular Weight
47139.86 Da

Drug created on December 03, 2015 16:51 / Updated on February 21, 2021 18:52