Reversing anticoagulants

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Pharmacologic interventions for reversing the effects of oral anticoagulants.

PURPOSE To describe the pharmacologic agents and strategies used for urgent reversal of warfarin and the target-specific oral anticoagulants dabigatran, rivaroxaban, and apixaban. SUMMARY To reverse the anticoagulant effects of warfarin in patients who are bleeding or need surgery, exogenous vitamin K (phytonadione) may be used in combination with another, shorter-acting intervention, such as...

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Reversing anticoagulant effects of novel oral anticoagulants: role of ciraparantag, andexanet alfa, and idarucizumab

Novel oral anticoagulants (NOACs) are increasingly used in clinical practice, but lack of commercially available reversal agents is a major barrier for mainstream use of these therapies. Specific antidotes to NOACs are under development. Idarucizumab (aDabi-Fab, BI 655075) is a novel humanized mouse monoclonal antibody that binds dabigatran and reverses its anticoagulant effect. In a recent Pha...

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Role of agents for reversing the effects of target-specific oral anticoagulants.

PURPOSE The available clinical data on target-specific oral anticoagulant (TSOAC) reversal agents that are currently in development or have been approved by the Food and Drug Administration (FDA) are reviewed. SUMMARY The development of TSOACs such as dabigatran, rivaroxaban, edoxaban, and apixaban has presented benefits and new challenges. One of the main challenges associated with the use o...

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Reversing the new oral anticoagulants with prothrombin complex concentrates (PCCs): what is the evidence?

Newer oral anticoagulants offer several advantages over traditional agents (e.g. warfarin), but they are still associated with a bleeding risk and currently there is no validated reversal treatment for them. While there is little support for the use of fresh frozen plasma, and limited data available on the effects of activated recombinant factor VII, preclinical data suggest that prothrombin co...

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An Overview of Novel Anticoagulants

Arterial and venous thromboembolism is one of the most common causes of death worldwide. For almost seventy years, heparin, low molecular weight heparin, and vitamin K antagonists have been widely used in the prevention and treatment of thromboembolic disorders. However, many of the limitations of these traditional anticoagulants have led to the search for and attempts to introduce better drug ...

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ژورنال

عنوان ژورنال: Nature Reviews Drug Discovery

سال: 2014

ISSN: 1474-1776,1474-1784

DOI: 10.1038/nrd4521