Drug General Information (ID: DDIQRN2Y8D)
Drug Name			Dexamethasone		Drug Info		Desirudin		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiinflammatory Agents				Anticoagulants
Structure

Mechanism of Dexamethasone-Desirudin Interaction (Severity Level: Major)
Increased risk of bleeding Click to Show/Hide Mechanism Graph
Drug Name		Dexamethasone				Desirudin
Mechanism		Risk of bleeding				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 Dexamethasone and Desirudin

Recommended Action
Management		During prophylaxis of venous thromboembolism, concomitant treatment with heparins or dextrans is not recommended. The effects of desirudin and unfractionated heparins on prolongation of activated partial thromboplastin time (aPTT) are additive. In general, any agent which may enhance the risk of hemorrhage should be discontinued prior to initiation of desirudin therapy. If coadministration is necessary, it should be undertaken with caution and only after thorough assessment of risks and benefits. Close clinical and laboratory observation for bleeding complications is recommended.

References
1	Product Information. Ipravask (desirudin). Aventis Pharmaceuticals, Swiftwater, PA.