Ver el código de «Dabigatran reversal»

==Background==
*Brand name Pradaxa
*If aPTT is <1.5 x control, it is unlikely that significant drug effect is present
*Thrombin Time (TT) is most sensitive; normal TT excludes presence of significant dabigatran

==Mild Bleeding==
*Local control measures: direct pressure
*Delay next 1-2 doses '''OR''' discontinue (as appropriate)

==[[hemorrhage|Moderate-Severe Bleeding]]==
*Local control measures: direct pressure/surgical intervention
*Resuscitate with intravenous [[IVF|fluid]] and / [[blood products]]
*Oral [[charcoal]] administration ''if drug taken <2 hours before presentation''
*[[Hemodialysis]] will remove ~60% of drug taken over prior 2-3 hours
*Consider [[Idarucizumab]] ([[Praxbind]]): 5 grams IV

==[[hemorrhage|Life-Threatening Bleeding]]==
*[[Idarucizumab]] (Praxbind): 5 grams IV

In addition, consider above PLUS
*Consider FEIBA<ref>Dager WE, Gosselin RC, Roberts AJ. "Reversing dabigatran in life-threatening bleeding occurring during cardiac ablation with factor eight inhibitor bypassing activity". Crit Care Med. 2013 May;41(5):e42-6.</ref>
*Consider Recombinant Factor VIIa (no good data)
*Consider [[Prothrombin Complex Concentrate|Kcentra]] (PCC): 50 IU/kg IV bolus<ref>Eerenberg ES, et al. "Reversal of Rivaroxaban and Dabigatran by Prothrombin Complex Concentrate: A randomized, placebo-controlled, crossover study in healthy subjects".  Circulation. 2011 Sep 6.</ref>
*Consider Tranexamic acid

==See Also==
*[[Coagulopathy (Main)]]
*[[Anticoagulants]]
*[[Idarucizumab]]
*[[Anticoagulant reversal for life-threatening bleeds]]

==References==
<references/>

[[Category:Heme/Onc]]
[[Category:Pharmacology]]