Direct Thrombin Inhibitor Reversal

Dabigatran

  • Consider activated charcoal if dose taken within past 2 hours

  • Idarucizumab (Praxbind) 5 g IV (given as 2 consecutive 2.5 g infusions), if available

  • Consider hemodialysis

  • Consider Factor VIIa or Feiba NF (activated PCC) administration for life-threatening bleed

Lepirudin, Bivalrudin, and Argatroban

  • No antidote exists

  • Consider hemodialysis (for lepirudin and bivalirudin)

  • Consider Factor VIIa or Feiba NF (activated PCC) administration for life-threatening bleed