Iprivask

Iprivask is a prescription medication used to prevent blood clots during hip replacement surgery. Iprivask belongs to a group of drugs called direct thrombin inhibitors.  These work by blocking a substance made in the body that helps to form blood clots.

This medication is available in an injectable form to be given directly under the skin (subcutaneously) by a healthcare provider.

Common side effects of Iprivask include bleeding, injection site irritation, anemia, and nausea.

Iprivask is a prescription medication used to prevent blood clots during hip replacement surgery.

This medication may be prescribed for other uses.  Ask your doctor or pharmacist for more information.

Your doctor will determine your exact dose and how often this medicine will be given. The dose your doctor recommends will be based on your bleeding risk and kidney function.

The recommended dose of Iprivask is 15 mg injected subcutaneously (under the skin) every 12 hours for up to 12 days, with the first dose being given immediately prior to your surgery. This dose may need to be reduced if your kidneys do not work as well as they should.

WARNING: SPINAL/EPIDURAL HEMATOMAS

When neuraxial anesthesia (epidural/spinal anesthesia) or spinal puncture is employed, patients anticoagulated or scheduled to be anticoagulated with selective inhibitors of thrombin such as Iprivask may be at risk of developing an epidural or spinal hematoma which can result in long-term or permanent paralysis.

Serious side effects have been reported with Iprivask including the following:

Spinal/Epidural Hematoma. In patients who receive Iprivask and need to have spinal or epidural anesthesia at the same time, there is a risk of accumulating blood in the subdural or epidural space in the spine, called a hematoma. This is a serious condition that requires immediate medical attention. Alert your physician if you develop back pain, tingling, numbness (especially in the lower limbs), muscle weakness, or the inability to hold in urine or stool.

Increased risk of bleeding. Iprivask increased the risk of major bleeding in certain patients. Tell your doctor if you have any signs of bleeding or bruising, or if you have or have had any of the following:

• kidney disease
• recent major surgery
• organ biopsy in the last month
• history of hemorrhagic stroke
• bleeding that occurred inside your skull or in your eyes
• recent ischemic stroke
• severe uncontrolled high blood pressure
• an infection of the heart's inner lining or heart valves, called bacterial endocarditis
• a disorder that affects bleeding, such as hemophilia, Von Willebrand disease, sickle cell disease, or liver disease

You should not receive Iprivask if you:

• are allergic to Iprivask or to any of its ingredients 
• have had an allergic reaction to similar medications such as bivalirudin (Angiomax)
• have an active bleed
• have a disorder that affects your ability to clot blood that cannot be reversed

Serious side effects have been reported with Iprivask. See the "Drug Precautions" section.

Common side effects of Iprivask include the following:

• anemia (blood does not carry enough oxygen to the rest of the body)
• nausea
• bleeding
• injection site irritation

This is not a complete list of Iprivask side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• anticoagulant (blood thinner) medications such as warfarin (Coumadin, Jantoven), heparin, enoxaparin (Lovenox), fondaparinux (Arixtra), rivaroxaban (Xarelto), and apixaban (Eliquis)
• antiplatelets (a type of blood thinner)  such as clopidogrel (Plavix), aspirin, prasugrel (Effient), ticagrelor (Brilinta), ticlopidine (Ticlid), abciximab (ReoPro), eptifibatide (Integrilin), tirofiban (Aggrastat), dipyridamole (Persantine), and cilostazol (Pletal)
• selective serotonin reuptake inhibitors such as escitalopram (Lexapro), paroxetine (Paxil), and fluoxetine (Prozac)
• aspirin and other NSAIDs (nonsteroidal anti-inflammatory drugs) such as:
  • celecoxib (Celebrex)
  • diclofenac (Cambia, Cataflam, Flector, Voltaren, Zipsor and others)
  • etodolac (Lodine)
  • ibuprofen (Advil, Motrin, Nuprin)
  • indomethacin (Indocin, Indocin SR)
  • ketoprofen (Orudis, Actron, Oruvail)
  • ketorolac (Toradol)
  • meloxicam (Mobic)
  • nabumetone (Relafen)
  • naproxen (Naprosyn)
  • naproxen sodium (Aleve, Anaprox, Naprelan)
  • oxaprozin (Daypro)
  • piroxicam (Feldene)

This is not a complete list of Iprivask drug interactions. Ask your doctor or pharmacist for more information.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Iprivask falls into category C. In animal studies, pregnant animals were given this medication and had some babies born with problems. Based on animal data, Iprivask may cause harm to your unborn baby. No well-controlled studies have been done in humans. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Tell your doctor if you are breastfeeding or plan to breastfeed.

It is not known if Iprivask crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using Iprivask.