Anticoagulant reversal for life-threatening bleeds: Difference between revisions
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*Monitor anti-Xa activity level to confirm reversal | *Monitor anti-Xa activity level to confirm reversal | ||
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| [[Enoxaparin]] (Lovenox®)||||||As above | | [[Enoxaparin]] (Lovenox®)||3-5 hrs (longer in renal impairment)||~ 20%||As above | ||
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| [[Hepari]]n||30-90 min (dose dependent)||Partial|| | | [[Hepari]]n||30-90 min (dose dependent)||Partial|| |
Revision as of 07:13, 25 March 2016
Factor Xa Inhibitors
Anticoagulant | Half-life | Removed by HD | Strategies to reverse or minimize anticoagulant effects |
Apixaban (Eliquis®) | 8-15 hrs (longer in renal impairment) | No |
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Edoxaban (Savaysa®) | 10-14 hrs (longer in renal impairment) | ~ 25% | As above |
Rivaroxaban (Xarelto®) | 9-13 hrs (longer in renal impairment) | No | As above |
Fondaparinux (Arixtra®) | 17-21 hrs (significantly longer in renal impairment) | No | 4-factor PCC (Kcentra™)^ 50 units/kg—max 5000 units |
Direct Thrombin Inhibitor
Anticoagulants | Half-life | Removed by HD | Strategies to reverse or minimize anticoagulant effects |
Argatroban | 40-50 min | ~ 20% | Turn off infusion |
Bivalirudin (Angiomax®) | 25 min (up to 1 hr in severe renal impairment) | ~ 25% | As above |
Dabigatran (Pradaxa®) | 14-17 hrs (up to 34 hrs in severe renal impairment) | ~ 65% |
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Heparins
Anticoagulants | Half-life | Removed by HD | Strategies to reverse or minimize anticoagulant effects |
Dalteparin (Fragmin®) | 3-5 hrs (longer in renal impairment) | ~ 20% |
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Enoxaparin (Lovenox®) | 3-5 hrs (longer in renal impairment) | ~ 20% | As above |
Heparin | 30-90 min (dose dependent) | Partial |
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^Off-label