Table 3. Dosing Adjustments for Lepirudin
|
Creatinine
Clearance (ml/min)
|
Serum
Creatinine (mg/dl)
|
Adjusted
Infusion Rate
|
|
|
%
of Standard Initial Infusion Rate
|
mg/kg/hr
|
||
|
45
to 60
|
1.6
to 2.0
|
50
%
|
0.075
|
|
30
to 44
|
2.1
to 3.0
|
30
%
|
0.045
|
|
15
to 29
|
3.1
to 6.0
|
15
%
|
0.0225
|
|
<15
|
>6.0
|
AVOID
OR STOP INFUSION
|
|
|
Hemodialysis
patients
|
|
Administer 0.1 mg/kg every other day only if the aPTT falls below the lower therapeutic limit of 1.5 | |
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