Anticoagulant | Reversal agent (all are given intravenously) |
Dabigatran (Pradaxa; oral thrombin inhibitor) |
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Oral factor Xa inhibitors:
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Reversal agents carry a risk of life-threatening thrombosis and should only be used under the direction of a specialist with expertise in their use and/or in a patient at imminent risk of death from bleeding. In general, a single dose is given; dosing may be repeated in rare situations in which the oral anticoagulant persists for longer in the circulation, such as severe kidney dysfunction.
Andexanet dosing is as follows:Refer to UpToDate topics on treatment of bleeding in patients receiving a DOAC or perioperative management of patients receiving a DOAC for additional information on administration, risks, and alternative therapies.
DOAC: direct oral anticoagulant; FEIBA: factor eight inhibitor bypassing activity; PCC: prothrombin complex concentrate.
* If idarucizumab is unavailable, an activated PCC (FEIBA, 50 to 80 units per kg intravenously) may be a reasonable alternative.Do you want to add Medilib to your home screen?