Desirudin

Also known as: Iprivask, Revasc, Recombinant hirudin, CGP 39393

A recombinant hirudin (direct thrombin inhibitor) once FDA-approved as Iprivask (2003) to prevent clots after hip replacement. Discontinued in the US.

Last updated October 26, 2026

Mechanism of Action

Desirudin is a 65-amino-acid recombinant form of hirudin, the anticoagulant protein from the medicinal leech. It binds thrombin's active site and fibrinogen-binding exosite almost irreversibly, inhibiting both free and clot-bound thrombin without needing antithrombin. It is cleared mainly by the kidneys, so exposure rises with kidney impairment.

Half-life: ~2-3 hours (subcutaneous)
Administration Routes: Subcutaneous
Research Status: Clinical

Reported Benefits

Prevention of deep vein thrombosis after elective hip replacement (former approved use)
Compared favorably with enoxaparin and heparin in hip-replacement trials
Studied as a non-heparin option in suspected heparin-induced thrombocytopenia

Potential Side Effects

Boxed warning: spinal or epidural hematoma with neuraxial anesthesia
Bleeding and hemorrhage
Injection-site mass, wound secretion
Antihirudin antibodies and hypersensitivity

Common Dosing

When marketed, desirudin was given as a subcutaneous injection twice daily starting shortly before hip-replacement surgery and continued for a limited period afterward, with dose reduction in kidney impairment. It is no longer available in the US. Dosing is set and supervised by the prescribing clinician.

The dosing information above is aggregated from research literature and anecdotal community reports for educational purposes only. It is not a recommendation, prescription, or medical advice. Peptides are sold as research chemicals only and are not intended for human use.

Contraindications

Known hypersensitivity to natural or recombinant hirudins
Active bleeding or irreversible coagulation disorders
Caution with spinal or epidural anesthesia (boxed warning)

No documented stacking partners for Desirudin yet.

A comparison of recombinant hirudin with a low-molecular-weight heparin to prevent thromboembolic complications after total hip replacement
1997
View
Prevention of thromboembolism with use of recombinant hirudin. Results of a double-blind, multicenter trial comparing the efficacy of desirudin (Revasc) with that of unfractionated heparin in patients having a total hip replacement
1997
View
A randomized, open-label pilot study comparing desirudin and argatroban in patients with suspected heparin-induced thrombocytopenia with or without thrombosis: PREVENT-HIT Study
2011
View

The FDA approved desirudin as Iprivask in 2003 to prevent deep vein thrombosis after elective hip replacement, but it has since been discontinued in the United States. It was also marketed in Europe as Revasc.

Both are direct thrombin inhibitors modeled on leech hirudin. Desirudin is the full recombinant protein given subcutaneously, while bivalirudin is a shorter synthetic peptide given intravenously, with a shorter, more reversible effect.