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

Scott Kaatz, Peter A. Kouides, David A. Garcia, Alex C. Spyropolous, Mark Crowther, Jim D. Douketis, Anthony K.C. Chan, Andra James, Stephan Moll, Thomas L. Ortel, Elizabeth M. Van Cott, Jack Ansell

Research output: Contribution to journalArticlepeer-review

320 Scopus citations


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.

Original languageEnglish
Pages (from-to)S141-S145
JournalAmerican Journal of Hematology
Issue numberSUPPL. 1
StatePublished - May 2012
Externally publishedYes


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