Lepirudin (Refludan) is a recombinant derivative of hirudin that is a direct thrombin inhibitor which is used as an anticoagulant in patients with heparin-induced thrombocytopenia. Hirudin was isolated initially from the salivary glands of medicinal leeches. It has a short half-life (about 1.3 hours in normal volunteers) and shows no cross-reactivity with anti-heparin antibodies. It is expensive, with a week's therapy costing thousands of dollars.

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