Anticoagulant reversal for life-threatening bleeds: Difference between revisions
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*Monitor anti-Xa activity level to confirm reversal | *Monitor anti-Xa activity level to confirm reversal | ||
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| [[Enoxaparin]] (Lovenox®)||||||As above | | [[Enoxaparin]] (Lovenox®)||3-5 hrs (longer in renal impairment)||~ 20%||As above | ||
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| [[Hepari]]n||30-90 min (dose dependent)||Partial|| | | [[Hepari]]n||30-90 min (dose dependent)||Partial|| | ||
Revision as of 07:13, 25 March 2016
Factor Xa Inhibitors
| Anticoagulant | Half-life | Removed by HD | Strategies to reverse or minimize anticoagulant effects |
| Apixaban (Eliquis®) | 8-15 hrs (longer in renal impairment) | No |
|
| Edoxaban (Savaysa®) | 10-14 hrs (longer in renal impairment) | ~ 25% | As above |
| Rivaroxaban (Xarelto®) | 9-13 hrs (longer in renal impairment) | No | As above |
| Fondaparinux (Arixtra®) | 17-21 hrs (significantly longer in renal impairment) | No | 4-factor PCC (Kcentra™)^ 50 units/kg—max 5000 units |
Direct Thrombin Inhibitor
| Anticoagulants | Half-life | Removed by HD | Strategies to reverse or minimize anticoagulant effects |
| Argatroban | 40-50 min | ~ 20% | Turn off infusion |
| Bivalirudin (Angiomax®) | 25 min (up to 1 hr in severe renal impairment) | ~ 25% | As above |
| Dabigatran (Pradaxa®) | 14-17 hrs (up to 34 hrs in severe renal impairment) | ~ 65% |
|
Heparins
| Anticoagulants | Half-life | Removed by HD | Strategies to reverse or minimize anticoagulant effects |
| Dalteparin (Fragmin®) | 3-5 hrs (longer in renal impairment) | ~ 20% |
|
| Enoxaparin (Lovenox®) | 3-5 hrs (longer in renal impairment) | ~ 20% | As above |
| Heparin | 30-90 min (dose dependent) | Partial |
|
^Off-label