Desirudin is a 65-amino-acid recombinant hirudin variant (MW ~6963.5 g/mol) that acts as a highly specific, irreversible direct thrombin inhibitor. It was FDA-approved in 2003 (Iprivask) for the prophylaxis of deep vein thrombosis (DVT) in patients undergoing elective hip replacement surgery. Desirudin is produced by recombinant DNA technology in Saccharomyces cerevisiae and is nearly identical to natural hirudin from the medicinal leech (Hirudo medicinalis), differing at two amino acid positions.
Category: Cardiovascular / Antithrombotic. Evidence rating: A (strong human clinical data).
Clinical status: FDA-approved (Iprivask for DVT prophylaxis post hip replacement, 2003)
Desirudin binds to thrombin with extremely high affinity (Ki ~10^-13 M), forming a nearly irreversible 1:1 stoichiometric complex. Like natural hirudin, desirudin binds to both the active catalytic site and the anion-binding exosite 1 of thrombin, completely blocking all thrombin functions:…
Safety considerations: Common: bleeding is the primary adverse effect; major hemorrhage reported in approximately 1-2% of patients in clinical trials; Injection site mass (4%), wound secretion, anemia, and nausea reported in clinical trials; Anti-hirudin antibodies may develop (rare); clinical significance uncertain, but may alter pharmacokinetics and rarely cause anaphylaxis.
Reviewed by the PeptideAtlas Editorial Team.
| Molecular weight | ~6963.5 g/mol |
|---|---|
| CAS number | 120993-53-5 |
| Half-life | ~2-3 hours (subcutaneous) |
| Bioavailability | ~90-100% subcutaneous |
| Production method | recombinant |
| Anti-doping status | not-listed |
| US regulatory status | FDA-approved (Iprivask, 2003) for DVT prophylaxis in patients undergoing elective hip replacement surgery. Limited availability. |
Related peptides: Bivalirudin.
Both are thrombin inhibitors derived from hirudin concepts, but they differ significantly. Desirudin is a full-length 65-AA recombinant hirudin analog with near-irreversible thrombin binding (Ki ~10^-13 M) and a 2-3 hour half-life given subcutaneously. Bivalirudin is a shorter 20-AA synthetic peptide with reversible binding and a 25-minute IV half-life. Desirudin is approved for SC DVT…
Desirudin (Iprivask) has had limited market availability. Its clinical use has been largely superseded by newer anticoagulants including direct oral anticoagulants (DOACs) such as rivaroxaban and apixaban for DVT prophylaxis. Check current formulary availability.
Desirudin is a recombinant version of hirudin, the anticoagulant protein originally discovered in the salivary glands of the medicinal leech Hirudo medicinalis. Leeches inject hirudin to prevent blood clotting while feeding. Desirudin differs from natural hirudin at two amino acid positions and is produced in yeast, not extracted from leeches.