Guidance on the emergent reversal of oral thrombin and factor Xa inhibitors.

Journal Article (Journal Article;Review)

The new oral anticoagulants dabigatran, rivaroxaban and apixaban have advantages over warfarin which include no need for laboratory monitoring, less drug-drug interactions and less food-drug interactions. However, there is no established antidote for patients who are bleeding or require emergent surgery and there is a paucity of evidence to guide the clinical care during these situations. Members of thrombosis and anticoagulation groups participating in the Thrombosis and Hemostasis Summit of North America formulated expert opinion guidance for reversing the anticoagulant effect of the new oral anticoagulants and suggest: routine supportive care, activated charcoal if drug ingestion was within a couple of hours, and hemodialysis if feasible for dabigatran. Also, the pros and cons of the possible use of four factor prothrombin complex concentrate are discussed.

Full Text

Duke Authors

Cited Authors

  • Kaatz, S; Kouides, PA; Garcia, DA; Spyropolous, AC; Crowther, M; Douketis, JD; Chan, AKC; James, A; Moll, S; Ortel, TL; Van Cott, EM; Ansell, J

Published Date

  • May 2012

Published In

Volume / Issue

  • 87 Suppl 1 /

Start / End Page

  • S141 - S145

PubMed ID

  • 22473649

Electronic International Standard Serial Number (EISSN)

  • 1096-8652

Digital Object Identifier (DOI)

  • 10.1002/ajh.23202


  • eng

Conference Location

  • United States