Drug General Information (ID: DDI9ULHQNM)
Drug Name			Drotrecogin alfa		Drug Info		Heparin		Drug Info
Drug Type		Protein/peptide				Small molecule
Therapeutic Class		Coagulation Modifiers				Anticoagulants

Mechanism of Drotrecogin alfa-Heparin Interaction (Severity Level: Major)
Increased risk of bleeding Click to Show/Hide Mechanism Graph
Drug Name		Drotrecogin alfa				Heparin
Mechanism		Risk of bleeding Anticoagulant effects				Risk of bleeding Anticoagulant
Key Mechanism Factor 1
		Factor Name		Bleeding
		Factor Description		Patients may be at risk for bleeding when the outcome of a disease or disease treatment confounds the standard mechanisms for maintaining hemostasis. Signs or symptoms of abnormal bleeding include: bleeding that takes a long time to stop (including nosebleeds, bleeding gums, bleeding from cuts and abrasions, and menstrual bleeding); severe unexplained bruising, or bruising that becomes larger; blood in the urine or stool, etc.
Mechanism Description		Increased risk of bleeding by the combination of Drotrecogin alfa and Heparin

Recommended Action
Management		When making the decision to administer drotrecogin alfa, the increased risk of bleeding versus the benefits of therapy should be carefully considered in seriously ill sepsis patients who are concurrently receiving therapeutic heparin (greater than 15 units/kg/hour). Close clinical and laboratory observation for bleeding complications is recommended if concurrent therapy is necessary. In clinical trials, prophylactic low doses of heparin did not appear to affect safety however, the efficacy of concurrent drotrecogin alfa and heparin in treating sepsis patients has not been determined.

References
1	Product Information. Xigris (drotrecogin alfa). Lilly, Eli and Company, Indianapolis, IN.