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Am J Hematol. 2012 May;87 Suppl 1:S141-5. doi: 10.1002/ajh.23202. Epub 2012 Apr 4.

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

Author information

  • 1Department of Medicine, Henry Ford Hospital, Detroit, Michigan 48202, USA. skaatz1@hfhs.org.

Erratum in

  • Am J Hematol. 2012 Jul;87(7):748.

Abstract

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.

Copyright © 2012 Wiley Periodicals, Inc.

PMID:
22473649
[PubMed - indexed for MEDLINE]
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