Difference between revisions of "Dabigatran reversal"

(Source)
(Source)
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*Hennipin County Guidelines
 
*Hennipin County Guidelines
 
*University of Utah Healthcare Thrombosis Service Guidelines
 
*University of Utah Healthcare Thrombosis Service Guidelines
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 +
==See Also==
 +
[[Warfarin (Coumadin) Reversal]]
  
 
[[Category:Heme/Onc]]
 
[[Category:Heme/Onc]]
 
[[Category:Drugs]]
 
[[Category:Drugs]]

Revision as of 18:28, 9 June 2012

Background

  • If aPTT is totally normal (<1.5x control), it is unlikely that significant drug effect is present
  • Thrombin Time (TT) is most sensitive; normal TT excludes presence of significant dabigatran

Reversal Protocol

  1. Mild Bleeding
    1. Local control measures
    2. Delay next 1-2 dose OR discontinue as appropriate
  2. Moderate-Severe Bleeding
    1. Local control measures/surgical intervention
    2. Symptomatic treatment
    3. Fluids/blood/monitoring
    4. Oral charcoal administration (if taken <2hrs before)
    5. Hemodialysis (removes 60% over 2-3hrs)
  3. Life-Threatening Bleeding
    1. All above
    2. Consider:
      1. rFVIIa
      2. Prothrombin Complex Concentrate (PCC); (Trad Name = Cofact)
        1. 50 IU/kg IV bolus

Source

  • Hennipin County Guidelines
  • University of Utah Healthcare Thrombosis Service Guidelines

See Also

Warfarin (Coumadin) Reversal