Recombinant hirudin in clinical practice - Focus on lepirudin

Clinical applications for recombinant hirudins have been investigated for t he past 10 years. The first indication for which a hirudin-lepirudin-has be en approved is treatment of heparin-induced thrombocytopenia (HIT). Also, t he recently completed trials for use of lepirudin in unstable angina indica te a potentially new indication. This review describes pharmacology and cli nical applications of lepirudin with an emphasis on HIT and unstable angina . An overview of usage of lepirudin in acute coronary syndromes is given, a s well as a summary of rare indications for lepirudin, such as extracorpore al circulation, for which comprehensive data are lacking.